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 $933.25 Median $977.24 Typical High $1,258.93 | Professional | None | $933.25 | $977.24 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $1,659.59 | Facility | None | $512.86 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,862.09 | Professional | None | $741.31 | $954.99 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,318.26 | $2,187.76 |
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 $676.08 Median $933.25 Typical High $2,344.23 | Professional | None | $676.08 | $933.25 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,819.70 | Professional | None | $776.25 | $776.25 | $1,819.70 |
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 $467.74 Median $489.78 Typical High $630.96 | Professional | 52 · Reduced service | $467.74 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $257.04 | Professional | 53 · Discontinued | $186.21 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $741.31 Typical High $954.99 | Professional | 54 · Surgery only | $707.95 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $190.55 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $691.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $660.69 | $691.83 | $891.25 |
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
$933
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.