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 $316.23 Median $446.68 Typical High $512.86 | Professional | None | $316.23 | $446.68 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | None | $323.59 | $354.81 | $354.81 |
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 $288.40 Median $446.68 Typical High $724.44 | Professional | None | $288.40 | $446.68 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $912.01 | Professional | None | $524.81 | $602.56 | $912.01 |
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 $245.47 Median $389.05 Typical High $891.25 | Professional | None | $245.47 | $389.05 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $831.76 | Professional | None | $302.00 | $302.00 | $831.76 |
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 $158.49 Median $199.53 Typical High $257.04 | Professional | 52 · Reduced service | $158.49 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $63.10 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $302.00 Typical High $389.05 | Professional | 54 · Surgery only | $239.88 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $60.26 Typical High $77.62 | Professional | 55 · Aftercare only | $47.86 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $51.29 | Professional | 56 · Pre-op care only | $31.62 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $281.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $223.87 | $281.84 | $363.08 |
Where Maryland sits
The same service costs 5.2 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
$389
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.