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 $478.63 Median $478.63 Typical High $512.86 | Professional | None | $478.63 | $478.63 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | None | $371.54 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,258.93 Typical High $2,041.74 | Facility | None | $331.13 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $436.52 | Professional | None | $316.23 | $363.08 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $562.34 | Professional | None | $371.54 | $407.38 | $562.34 |
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 $251.19 Median $338.84 Typical High $691.83 | Professional | None | $251.19 | $338.84 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $575.44 | Professional | None | $281.84 | $281.84 | $575.44 |
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 $239.88 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $363.08 |
Where Maryland sits
The same service costs 7.4 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
$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.