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 $707.95 Median $707.95 Typical High $741.31 | Professional | None | $707.95 | $707.95 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | None | $707.95 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $1,819.70 | Facility | None | $512.86 | $977.24 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,318.26 | Professional | None | $660.69 | $691.83 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,288.25 | Professional | None | $707.95 | $812.83 | $1,288.25 |
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 $549.54 Median $691.83 Typical High $1,513.56 | Professional | None | $549.54 | $691.83 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,071.52 | Professional | None | $676.08 | $676.08 | $1,071.52 |
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 $354.81 Median $354.81 Typical High $371.54 | Professional | 52 · Reduced service | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $524.81 |
Where Maryland sits
The same service costs 5.9 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
$741
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.