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 $354.81 Median $398.11 Typical High $602.56 | Professional | None | $354.81 | $398.11 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | None | $275.42 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,122.02 Typical High $2,089.30 | Facility | None | $707.95 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $501.19 | Professional | None | $263.03 | $407.38 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $724.44 | Professional | None | $446.68 | $524.81 | $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 $223.87 Median $354.81 Typical High $660.69 | Professional | None | $223.87 | $354.81 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $758.58 | Professional | None | $354.81 | $354.81 | $758.58 |
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 $173.78 Median $194.98 Typical High $302.00 | Professional | 52 · Reduced service | $173.78 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $120.23 | Professional | 53 · Discontinued | $70.79 | $79.43 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $446.68 | Professional | 54 · Surgery only | $263.03 | $295.12 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $89.13 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $60.26 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $416.87 |
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· 46th of 51
$380
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.