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 $512.86 Median $512.86 Typical High $537.03 | Professional | None | $512.86 | $512.86 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | None | $489.78 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,737.80 | Facility | None | $446.68 | $977.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $933.25 | Professional | None | $416.87 | $489.78 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $977.24 | Professional | None | $575.44 | $645.65 | $977.24 |
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 $316.23 Median $467.74 Typical High $1,023.29 | Professional | None | $316.23 | $467.74 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $891.25 | Professional | None | $398.11 | $398.11 | $891.25 |
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 $257.04 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $389.05 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $371.54 |
Where Maryland sits
The same service costs 5.5 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· 40th of 51
$537
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.