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 $467.74 Median $467.74 Typical High $501.19 | Professional | None | $467.74 | $467.74 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
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 $416.87 Median $478.63 Typical High $851.14 | Professional | None | $416.87 | $478.63 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $851.14 | Professional | None | $467.74 | $524.81 | $851.14 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $3,890.45 | Facility | None | $954.99 | $2,137.96 | $3,890.45 |
United Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $1,000.00 | Professional | None | $363.08 | $446.68 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $724.44 | Professional | None | $446.68 | $446.68 | $724.44 |
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 $234.42 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $346.74 |
Where Maryland sits
The same service costs 6.3 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
$501
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.