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 $363.08 Median $407.38 Typical High $588.84 | Professional | None | $363.08 | $407.38 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | None | $309.03 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $426.58 Typical High $776.25 | Facility | None | $275.42 | $426.58 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $645.65 | Professional | None | $316.23 | $446.68 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $954.99 | Professional | None | $562.34 | $676.08 | $954.99 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $891.25 | Professional | None | $251.19 | $416.87 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $954.99 | Professional | None | $354.81 | $354.81 | $954.99 |
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 $177.83 Median $186.21 Typical High $295.12 | Professional | 52 · Reduced service | $177.83 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $117.49 | Professional | 53 · Discontinued | $72.44 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $436.52 | Professional | 54 · Surgery only | $269.15 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $89.13 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $58.88 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $251.19 | $263.03 | $407.38 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 51st of 51
$363
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.