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 $831.76 Median $933.25 Typical High $1,122.02 | Professional | None | $831.76 | $933.25 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | None | $831.76 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $2,691.53 | Facility | None | $512.86 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,737.80 | Professional | None | $794.33 | $1,023.29 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,348.96 | $1,995.26 |
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 $645.65 Median $912.01 Typical High $2,137.96 | Professional | None | $645.65 | $912.01 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,819.70 | Professional | None | $954.99 | $954.99 | $1,819.70 |
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 $416.87 Median $467.74 Typical High $562.34 | Professional | 52 · Reduced service | $416.87 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $165.96 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $616.60 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $123.03 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $575.44 | $660.69 | $776.25 |
Where Maryland sits
The same service costs 5.1 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· 45th of 51
$933
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.