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 $302.00 Median $446.68 Typical High $489.78 | Professional | None | $302.00 | $446.68 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | None | $309.03 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $1,659.59 | Facility | None | $512.86 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $707.95 | Professional | None | $288.40 | $436.52 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $851.14 | Professional | None | $501.19 | $562.34 | $851.14 |
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 $251.19 Median $398.11 Typical High $851.14 | Professional | None | $251.19 | $398.11 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $776.25 | Professional | None | $416.87 | $416.87 | $776.25 |
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 $151.36 Median $194.98 Typical High $245.47 | Professional | 52 · Reduced service | $151.36 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $97.72 | Professional | 53 · Discontinued | $60.26 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $288.40 Typical High $371.54 | Professional | 54 · Surgery only | $229.09 | $288.40 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $74.13 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $346.74 |
Where Maryland sits
The same service costs 5.2 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· 44th of 51
$407
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.