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 $204.17 Median $457.09 Typical High $676.08 | Professional | None | $204.17 | $457.09 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $239.88 | Professional | None | $173.78 | $190.55 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,445.44 Typical High $2,344.23 | Facility | None | $331.13 | $1,445.44 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $467.74 Typical High $660.69 | Professional | None | $177.83 | $467.74 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,000.00 | Professional | None | $501.19 | $724.44 | $1,000.00 |
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 $151.36 Median $389.05 Typical High $724.44 | Professional | None | $151.36 | $389.05 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $851.14 | Professional | None | $426.58 | $426.58 | $851.14 |
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 $102.33 Median $208.93 Typical High $338.84 | Professional | 52 · Reduced service | $102.33 | $208.93 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $83.18 Typical High $134.90 | Professional | 53 · Discontinued | $40.74 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $316.23 Typical High $512.86 | Professional | 54 · Surgery only | $151.36 | $316.23 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $63.10 Typical High $102.33 | Professional | 55 · Aftercare only | $30.90 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $44.67 Typical High $67.61 | Professional | 56 · Pre-op care only | $20.42 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $295.12 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $141.25 | $295.12 | $478.63 |
Where Maryland sits
The same service costs 3.9 times more in Alaska than in Washington, DC. 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· 50th 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.