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 $245.47 Median $354.81 Typical High $398.11 | Professional | None | $245.47 | $354.81 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | None | $251.19 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $676.08 | Facility | None | $223.87 | $354.81 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $588.84 | Professional | None | $239.88 | $354.81 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $707.95 | Professional | None | $398.11 | $457.09 | $707.95 |
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 $331.13 Typical High $724.44 | Professional | None | $208.93 | $331.13 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $616.60 | Professional | None | $251.19 | $251.19 | $616.60 |
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 $123.03 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $48.98 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $181.97 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $47.86 Typical High $60.26 | Professional | 55 · Aftercare only | $36.31 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $223.87 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $169.82 | $223.87 | $281.84 |
Where Maryland sits
The same service costs 4.3 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
$295
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.