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 $331.13 Median $389.05 Typical High $407.38 | Professional | None | $331.13 | $389.05 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $478.63 | Professional | None | $363.08 | $407.38 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $2,570.40 | Facility | None | $512.86 | $1,445.44 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $512.86 | Professional | None | $275.42 | $354.81 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $562.34 | Professional | None | $331.13 | $398.11 | $562.34 |
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 $169.82 Median $295.12 Typical High $562.34 | Professional | None | $169.82 | $295.12 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $478.63 | Professional | None | $251.19 | $251.19 | $478.63 |
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 $173.78 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $257.04 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $288.40 |
Where Maryland sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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· 28th of 51
$372
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.