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 $851.14 Median $912.01 Typical High $1,000.00 | Professional | None | $851.14 | $912.01 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,047.13 | Professional | None | $831.76 | $933.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,187.76 | Professional | None | $794.33 | $1,023.29 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,584.89 | Professional | None | $870.96 | $977.24 | $1,584.89 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,137.96 | Professional | None | $758.58 | $1,148.15 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,288.25 | Professional | None | $676.08 | $676.08 | $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 $457.09 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $691.83 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $691.83 |
Where Maryland sits
The same service costs 5.2 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· 41st of 51
$977
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.