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 $407.38 Median $426.58 Typical High $426.58 | Professional | None | $407.38 | $426.58 | $426.58 |
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 $1,659.59 Typical High $2,691.53 | Facility | None | $446.68 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $741.31 | Professional | None | $363.08 | $416.87 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $724.44 | Professional | None | $416.87 | $467.74 | $724.44 |
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 $309.03 Median $380.19 Typical High $851.14 | Professional | None | $309.03 | $380.19 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $645.65 | Professional | None | $380.19 | $380.19 | $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 $204.17 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $302.00 |
Where Maryland sits
The same service costs 6.8 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
$427
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.