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 $213.80 Median $275.42 Typical High $323.59 | Professional | None | $213.80 | $275.42 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | None | $194.98 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,023.29 Typical High $1,819.70 | Facility | None | $446.68 | $1,023.29 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $616.60 | Professional | None | $208.93 | $275.42 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $467.74 | Professional | None | $281.84 | $323.59 | $467.74 |
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 $186.21 Median $316.23 Typical High $616.60 | Professional | None | $186.21 | $316.23 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $426.58 | Professional | None | $213.80 | $213.80 | $426.58 |
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 $107.15 Median $117.49 Typical High $151.36 | Professional | 52 · Reduced service | $107.15 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $42.66 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $35.48 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $21.38 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $165.96 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $165.96 | $213.80 |
Where Maryland sits
The same service costs 4.5 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· 38th of 51
$302
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.