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 $524.81 Median $524.81 Typical High $588.84 | Professional | None | $524.81 | $524.81 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $776.25 | Professional | None | $630.96 | $707.95 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,290.87 Typical High $3,801.89 | Facility | None | $512.86 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,584.89 | Professional | None | $562.34 | $691.83 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,096.48 | Professional | None | $575.44 | $660.69 | $1,096.48 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $1,513.56 | Professional | None | $537.03 | $812.83 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Professional | None | $575.44 | $575.44 | $870.96 |
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 $263.03 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $371.54 | $416.87 |
Where Maryland sits
The same service costs 6.2 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· 41st of 51
$708
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.