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 $891.25 Median $977.24 Typical High $977.24 | Professional | None | $891.25 | $977.24 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | None | $794.33 | $870.96 | $870.96 |
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 $724.44 Median $891.25 Typical High $2,041.74 | Professional | None | $724.44 | $891.25 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,548.82 | Professional | None | $741.31 | $870.96 | $1,548.82 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $2,137.96 | Professional | None | $724.44 | $1,047.13 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,122.02 | Professional | None | $707.95 | $707.95 | $1,122.02 |
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 $446.68 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $676.08 |
Where Maryland sits
The same service costs 4.4 times more in Wisconsin 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· 47th of 51
$871
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.