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 $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,288.25 | $1,380.38 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,715.35 Typical High $6,456.54 | Facility | None | $512.86 | $3,715.35 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,318.26 | Professional | None | $954.99 | $1,000.00 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,445.44 | Professional | None | $977.24 | $1,023.29 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,089.30 | Professional | None | $891.25 | $1,047.13 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,479.11 | Professional | None | $851.14 | $851.14 | $1,479.11 |
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 $645.65 Median $645.65 Typical High $691.83 | Professional | 52 · Reduced service | $645.65 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $954.99 |
Where Maryland sits
The same service costs 8.9 times more in Wyoming 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
$1,122
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.