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 $478.63 Median $478.63 Typical High $489.78 | Professional | None | $478.63 | $478.63 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $524.81 | Professional | None | $380.19 | $426.58 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $3,090.30 Typical High $5,248.07 | Facility | None | $331.13 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $660.69 | Professional | None | $398.11 | $426.58 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $630.96 | Professional | None | $389.05 | $426.58 | $630.96 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $812.83 | Professional | None | $338.84 | $407.38 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $524.81 | Professional | None | $354.81 | $354.81 | $524.81 |
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 $239.88 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $338.84 |
Where Maryland sits
The same service costs 5.2 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· 43rd of 51
$427
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.