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 $630.96 Median $630.96 Typical High $660.69 | Professional | None | $630.96 | $630.96 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | None | $645.65 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $1,584.89 | Facility | None | $446.68 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,148.15 | Professional | None | $562.34 | $645.65 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,122.02 | Professional | None | $645.65 | $724.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $1,348.96 | Professional | None | $346.74 | $562.34 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $977.24 | Professional | None | $501.19 | $501.19 | $977.24 |
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 $316.23 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $478.63 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $467.74 |
Where Maryland sits
The same service costs 7.4 times more in Alaska than in Texas. 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· 41st of 51
$646
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.