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 $660.69 Median $676.08 Typical High $724.44 | Professional | None | $660.69 | $676.08 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $776.25 | Professional | None | $562.34 | $630.96 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,011.87 | Facility | None | $512.86 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $891.25 | Professional | None | $512.86 | $630.96 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $933.25 | Professional | None | $549.54 | $616.60 | $933.25 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,570.40 | Facility | None | $758.58 | $1,412.54 | $2,570.40 |
United Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $1,096.48 | Professional | None | $457.09 | $562.34 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $741.31 | Professional | None | $489.78 | $489.78 | $741.31 |
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 $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $501.19 |
Where Maryland sits
The same service costs 25.1 times more in Alaska 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· 34th of 51
$631
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.