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 $436.52 Median $446.68 Typical High $489.78 | Professional | None | $436.52 | $446.68 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | None | $416.87 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,023.29 Typical High $1,659.59 | Facility | None | $331.13 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $1,288.25 | Professional | None | $416.87 | $501.19 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $724.44 | Professional | None | $407.38 | $467.74 | $724.44 |
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 $371.54 Median $549.54 Typical High $1,096.48 | Professional | None | $371.54 | $549.54 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $616.60 | Professional | None | $338.84 | $338.84 | $616.60 |
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 $218.78 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $218.78 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $338.84 |
Where Maryland sits
The same service costs 5.1 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
$501
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.