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 $416.87 Median $524.81 Typical High $630.96 | Professional | None | $416.87 | $524.81 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | None | $416.87 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $2,187.76 | Facility | None | $446.68 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $912.01 | Professional | None | $389.05 | $549.54 | $912.01 |
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 $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $1,071.52 | Professional | None | $316.23 | $489.78 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,000.00 | Professional | None | $524.81 | $524.81 | $1,000.00 |
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 $208.93 Median $251.19 Typical High $316.23 | Professional | 52 · Reduced service | $208.93 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $100.00 Typical High $125.89 | Professional | 53 · Discontinued | $83.18 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $74.13 Typical High $93.33 | Professional | 55 · Aftercare only | $61.66 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $436.52 |
Where Maryland sits
The same service costs 5.2 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· 45th of 51
$513
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.