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 $758.58 Median $794.33 Typical High $794.33 | Professional | None | $758.58 | $794.33 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | None | $741.31 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,786.30 Typical High $7,943.28 | Facility | None | $512.86 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,348.96 | Professional | None | $645.65 | $741.31 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,348.96 | Professional | None | $707.95 | $812.83 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,621.81 | Professional | None | $588.84 | $724.44 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,096.48 | Professional | None | $724.44 | $724.44 | $1,096.48 |
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 $380.19 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $380.19 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 53 · Discontinued | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $562.34 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $549.54 |
Where Maryland sits
The same service costs 7.6 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· 40th of 51
$794
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.