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 $245.47 Median $288.40 Typical High $467.74 | Professional | None | $245.47 | $288.40 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $288.40 | Professional | None | $208.93 | $234.42 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $2,818.38 | Facility | None | $954.99 | $1,548.82 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $457.09 | Professional | None | $218.78 | $323.59 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $588.84 | Professional | None | $316.23 | $426.58 | $588.84 |
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 $181.97 Median $275.42 Typical High $512.86 | Professional | None | $181.97 | $275.42 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $501.19 | Professional | None | $257.04 | $257.04 | $501.19 |
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 $123.03 Median $141.25 Typical High $234.42 | Professional | 52 · Reduced service | $123.03 | $141.25 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $93.33 | Professional | 53 · Discontinued | $48.98 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $213.80 Typical High $346.74 | Professional | 54 · Surgery only | $186.21 | $213.80 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $42.66 Typical High $69.18 | Professional | 55 · Aftercare only | $37.15 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $46.77 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $199.53 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $173.78 | $199.53 | $323.59 |
Where Maryland sits
The same service costs 3.7 times more in Wyoming 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· 48th of 51
$257
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.