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 $776.25 Median $812.83 Typical High $870.96 | Professional | None | $776.25 | $812.83 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | None | $776.25 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $10,000.00 Typical High $16,982.44 | Facility | None | $630.96 | $10,000.00 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,380.38 | Professional | None | $691.83 | $776.25 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,380.38 | Professional | None | $758.58 | $870.96 | $1,380.38 |
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 $630.96 Median $741.31 Typical High $1,659.59 | Professional | None | $630.96 | $741.31 | $1,659.59 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | None | $776.25 | $776.25 | $1,174.90 |
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 $389.05 Median $389.05 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $562.34 |
Where Maryland sits
The same service costs 7.4 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· 41st of 51
$813
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.