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 $691.83 Median $707.95 Typical High $812.83 | Professional | None | $691.83 | $707.95 | $812.83 |
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 $758.58 Median $933.25 Typical High $2,137.96 | Professional | None | $758.58 | $933.25 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,479.11 | Professional | None | $776.25 | $891.25 | $1,479.11 |
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 $1,096.48 Typical High $2,089.30 | Professional | None | $741.31 | $1,096.48 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | None | $776.25 | $776.25 | $1,174.90 |
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 $346.74 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $562.34 |
Where Maryland sits
The same service costs 6.3 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· 42nd of 51
$851
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.