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 $323.59 Median $446.68 Typical High $501.19 | Professional | None | $323.59 | $446.68 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | None | $338.84 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $776.25 | Facility | None | $275.42 | $436.52 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $724.44 | Professional | None | $309.03 | $446.68 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $870.96 | Professional | None | $501.19 | $575.44 | $870.96 |
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 $269.15 Median $407.38 Typical High $891.25 | Professional | None | $269.15 | $407.38 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $776.25 | Professional | None | $426.58 | $426.58 | $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 $162.18 Median $199.53 Typical High $251.19 | Professional | 52 · Reduced service | $162.18 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $79.43 Typical High $100.00 | Professional | 53 · Discontinued | $64.57 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $295.12 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $39.81 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $275.42 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $275.42 | $346.74 |
Where Maryland sits
The same service costs 4.7 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
$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.