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 $389.05 Median $398.11 Typical High $426.58 | Professional | None | $389.05 | $398.11 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | None | $309.03 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $177.83 Typical High $302.00 | Facility | None | $50.12 | $177.83 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $389.05 | Professional | None | $288.40 | $302.00 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $549.54 | Professional | None | $338.84 | $389.05 | $549.54 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $630.96 | Professional | None | $223.87 | $288.40 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $549.54 | Professional | None | $257.04 | $257.04 | $549.54 |
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 $194.98 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $288.40 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $269.15 | $275.42 | $295.12 |
Where Maryland sits
The same service costs 6.6 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· 44th of 51
$309
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.