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 $416.87 Typical High $436.52 | Professional | None | $416.87 | $416.87 | $436.52 |
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 $512.86 Median $4,570.88 Typical High $7,585.78 | Facility | None | $512.86 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $741.31 | Professional | None | $380.19 | $426.58 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $741.31 | Professional | None | $416.87 | $478.63 | $741.31 |
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 $354.81 Median $426.58 Typical High $912.01 | Professional | None | $354.81 | $426.58 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $630.96 | Professional | None | $416.87 | $416.87 | $630.96 |
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 $208.93 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $309.03 | $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 $41.69 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $302.00 |
Where Maryland sits
The same service costs 6.8 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
$437
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.