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 $363.08 Median $467.74 Typical High $575.44 | Professional | None | $363.08 | $467.74 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | None | $363.08 | $398.11 | $398.11 |
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 $338.84 Median $501.19 Typical High $831.76 | Professional | None | $338.84 | $501.19 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,023.29 | Professional | None | $602.56 | $676.08 | $1,023.29 |
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 $288.40 Median $446.68 Typical High $1,000.00 | Professional | None | $288.40 | $446.68 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $933.25 | Professional | None | $467.74 | $467.74 | $933.25 |
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 $181.97 Median $229.09 Typical High $288.40 | Professional | 52 · Reduced service | $181.97 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $72.44 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $436.52 | Professional | 54 · Surgery only | $275.42 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $323.59 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $257.04 | $323.59 | $407.38 |
Where Maryland sits
The same service costs 5.1 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
$457
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.