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 $489.78 Median $660.69 Typical High $758.58 | Professional | None | $489.78 | $660.69 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | None | $489.78 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $3,162.28 | Facility | None | $1,000.00 | $1,698.24 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $1,071.52 | Professional | None | $457.09 | $630.96 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,230.27 | Professional | None | $724.44 | $831.76 | $1,230.27 |
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 $354.81 Median $537.03 Typical High $1,288.25 | Professional | None | $354.81 | $537.03 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,122.02 | Professional | None | $549.54 | $549.54 | $1,122.02 |
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 $245.47 Median $281.84 Typical High $354.81 | Professional | 52 · Reduced service | $245.47 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $141.25 | Professional | 53 · Discontinued | $97.72 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $371.54 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $107.15 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $489.78 |
Where Maryland sits
The same service costs 5.0 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· 46th of 51
$550
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.