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 $323.59 Median $354.81 Typical High $457.09 | Professional | None | $323.59 | $354.81 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | None | $269.15 | $302.00 | $302.00 |
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 $288.40 Median $398.11 Typical High $794.33 | Professional | None | $288.40 | $398.11 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $691.83 | Professional | None | $407.38 | $467.74 | $691.83 |
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 $281.84 Median $446.68 Typical High $831.76 | Professional | None | $281.84 | $446.68 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $630.96 | Professional | None | $316.23 | $316.23 | $630.96 |
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 $162.18 Median $173.78 Typical High $223.87 | Professional | 52 · Reduced service | $162.18 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $239.88 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $316.23 |
Where Maryland sits
The same service costs 4.9 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· 34th of 51
$447
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.