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 $257.04 Median $346.74 Typical High $426.58 | Professional | None | $257.04 | $346.74 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | None | $263.03 | $295.12 | $295.12 |
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 $251.19 Median $380.19 Typical High $630.96 | Professional | None | $251.19 | $380.19 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $758.58 | Professional | None | $426.58 | $478.63 | $758.58 |
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 $208.93 Median $346.74 Typical High $758.58 | Professional | None | $208.93 | $346.74 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $660.69 | Professional | None | $354.81 | $354.81 | $660.69 |
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 $128.82 Median $169.82 Typical High $213.80 | Professional | 52 · Reduced service | $128.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $67.61 Typical High $85.11 | Professional | 53 · Discontinued | $51.29 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $251.19 Typical High $323.59 | Professional | 54 · Surgery only | $194.98 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $38.90 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.88 Typical High $42.66 | Professional | 56 · Pre-op care only | $25.70 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $234.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $181.97 | $234.42 | $302.00 |
Where Maryland sits
The same service costs 5.5 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· 42nd of 51
$347
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.