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 $812.83 Median $812.83 Typical High $831.76 | Professional | None | $812.83 | $812.83 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | None | $776.25 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $2,691.53 | Facility | None | $489.78 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $2,290.87 | Professional | None | $741.31 | $891.25 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,318.26 | Professional | None | $724.44 | $831.76 | $1,318.26 |
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 $676.08 Median $1,023.29 Typical High $1,905.46 | Professional | None | $676.08 | $1,023.29 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,096.48 | Professional | None | $630.96 | $630.96 | $1,096.48 |
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 $407.38 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Where Maryland sits
The same service costs 5.9 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· 41st of 51
$871
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.