How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $602.56 | Professional | None | $512.86 | $549.54 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | None | $524.81 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $891.25 Typical High $1,584.89 | Facility | None | $331.13 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $1,000.00 | Professional | None | $467.74 | $549.54 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,122.02 | Professional | None | $645.65 | $741.31 | $1,122.02 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $1,174.90 | Professional | None | $380.19 | $501.19 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,023.29 | Professional | None | $489.78 | $489.78 | $1,023.29 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $416.87 |
Where Maryland sits
The same service costs 5.2 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 40th of 51
$550
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.