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 Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $851.14 | Facility | None | $549.54 | $549.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $457.09 | Professional | None | $281.84 | $398.11 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | None | $281.84 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $426.58 Typical High $676.08 | Facility | None | $257.04 | $426.58 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $660.69 | Professional | None | $269.15 | $407.38 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $794.33 | Professional | None | $457.09 | $524.81 | $794.33 |
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 $234.42 Median $371.54 Typical High $794.33 | Professional | None | $234.42 | $371.54 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $707.95 | Professional | None | $389.05 | $389.05 | $707.95 |
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 $141.25 Median $181.97 Typical High $229.09 | Professional | 52 · Reduced service | $141.25 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $72.44 Typical High $91.20 | Professional | 53 · Discontinued | $56.23 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $208.93 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $54.95 Typical High $69.18 | Professional | 55 · Aftercare only | $41.69 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $45.71 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $251.19 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $194.98 | $251.19 | $316.23 |
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· 44th of 51
$372
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.