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 $457.09 Median $489.78 Typical High $524.81 | Professional | None | $457.09 | $489.78 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $457.09 | Professional | None | $398.11 | $446.68 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,513.56 Typical High $2,398.83 | Facility | None | $446.68 | $1,513.56 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $1,122.02 | Professional | None | $407.38 | $537.03 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $794.33 | Professional | None | $426.58 | $489.78 | $794.33 |
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 $389.05 Median $575.44 Typical High $1,096.48 | Professional | None | $389.05 | $575.44 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $645.65 | Professional | None | $363.08 | $363.08 | $645.65 |
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 $263.03 | Professional | 52 · Reduced service | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $363.08 |
Where Maryland sits
The same service costs 6.5 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
$525
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.