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 $891.25 Median $891.25 Typical High $912.01 | Professional | None | $891.25 | $891.25 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | None | $851.14 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $2,570.40 | Professional | None | $812.83 | $977.24 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,445.44 | Professional | None | $794.33 | $912.01 | $1,445.44 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $2,089.30 | Professional | None | $741.31 | $1,122.02 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,202.26 | Professional | None | $691.83 | $691.83 | $1,202.26 |
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 $446.68 Median $446.68 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $645.65 |
Where Maryland sits
The same service costs 5.6 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· 44th of 51
$891
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.