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 $407.38 Median $537.03 Typical High $616.60 | Professional | None | $407.38 | $537.03 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | None | $416.87 | $457.09 | $457.09 |
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 $371.54 Median $537.03 Typical High $891.25 | Professional | None | $371.54 | $537.03 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,096.48 | Professional | None | $630.96 | $724.44 | $1,096.48 |
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 $323.59 Median $478.63 Typical High $1,071.52 | Professional | None | $323.59 | $478.63 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $977.24 | Professional | None | $398.11 | $398.11 | $977.24 |
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 $204.17 Median $245.47 Typical High $309.03 | Professional | 52 · Reduced service | $204.17 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $123.03 | Professional | 53 · Discontinued | $81.28 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $371.54 Typical High $467.74 | Professional | 54 · Surgery only | $302.00 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $93.33 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $61.66 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $346.74 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $281.84 | $346.74 | $436.52 |
Where Maryland sits
The same service costs 5.1 times more in Alaska than in Texas. 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
$479
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.