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 $380.19 Median $398.11 Typical High $426.58 | Professional | None | $380.19 | $398.11 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,818.38 | Facility | None | $512.86 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $1,148.15 | Professional | None | $363.08 | $446.68 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $645.65 | Professional | None | $363.08 | $426.58 | $645.65 |
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 $331.13 Median $478.63 Typical High $977.24 | Professional | None | $331.13 | $478.63 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $562.34 | Professional | None | $295.12 | $295.12 | $562.34 |
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 $190.55 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $77.62 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $275.42 | $302.00 |
Where Maryland sits
The same service costs 5.0 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· 40th of 51
$479
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.