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 $831.76 Median $870.96 Typical High $977.24 | Professional | None | $831.76 | $870.96 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | None | $831.76 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,570.88 Typical High $7,585.78 | Facility | None | $512.86 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,479.11 | Professional | None | $724.44 | $831.76 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,479.11 | Professional | None | $851.14 | $954.99 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,737.80 | Professional | None | $602.56 | $776.25 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Professional | None | $741.31 | $741.31 | $1,288.25 |
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 $416.87 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $602.56 |
Where Maryland sits
The same service costs 7.2 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· 40th of 51
$851
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.