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 $676.08 Median $676.08 Typical High $724.44 | Professional | None | $676.08 | $676.08 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | None | $676.08 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $2,691.53 | Facility | None | $512.86 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,230.27 | Professional | None | $588.84 | $676.08 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,230.27 | Professional | None | $691.83 | $776.25 | $1,230.27 |
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 $478.63 Median $616.60 Typical High $1,380.38 | Professional | None | $478.63 | $616.60 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,071.52 | Professional | None | $588.84 | $588.84 | $1,071.52 |
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 $338.84 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $512.86 |
Where Maryland sits
The same service costs 6.9 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· 42nd of 51
$676
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.