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 $436.52 Typical High $446.68 | Professional | None | $416.87 | $436.52 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | None | $416.87 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $4,677.35 Typical High $7,943.28 | Facility | None | $446.68 | $4,677.35 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $758.58 | Professional | None | $371.54 | $416.87 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $758.58 | Professional | None | $426.58 | $478.63 | $758.58 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $891.25 | Professional | None | $323.59 | $398.11 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $645.65 | Professional | None | $407.38 | $407.38 | $645.65 |
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 $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $309.03 |
Where Maryland sits
The same service costs 6.0 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· 41st of 51
$447
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.