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 $426.58 Median $524.81 Typical High $707.95 | Professional | None | $426.58 | $524.81 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | None | $426.58 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,162.28 | Facility | None | $1,348.96 | $1,698.24 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $1,000.00 | Professional | None | $398.11 | $575.44 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,202.26 | Professional | None | $707.95 | $794.33 | $1,202.26 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $3,090.30 | Facility | None | $758.58 | $1,412.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $1,174.90 | Professional | None | $338.84 | $512.86 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,096.48 | Professional | None | $537.03 | $537.03 | $1,096.48 |
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 $213.80 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service | $213.80 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $104.71 Typical High $141.25 | Professional | 53 · Discontinued | $85.11 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $389.05 Typical High $524.81 | Professional | 54 · Surgery only | $323.59 | $389.05 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $77.62 Typical High $104.71 | Professional | 55 · Aftercare only | $64.57 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $52.48 Typical High $70.79 | Professional | 56 · Pre-op care only | $42.66 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $302.00 | $363.08 | $489.78 |
Where Maryland sits
The same service costs 5.0 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· 43rd of 51
$537
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.