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 $426.58 Median $457.09 Typical High $501.19 | Professional | None | $426.58 | $457.09 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | None | $446.68 | $489.78 | $489.78 |
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 $389.05 Median $457.09 Typical High $831.76 | Professional | None | $389.05 | $457.09 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $954.99 | Professional | None | $549.54 | $630.96 | $954.99 |
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 $309.03 Median $416.87 Typical High $977.24 | Professional | None | $309.03 | $416.87 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $851.14 | Professional | None | $398.11 | $398.11 | $851.14 |
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 $213.80 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $87.10 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $354.81 |
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
$457
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.