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 $812.83 Median $812.83 Typical High $870.96 | Professional | None | $812.83 | $812.83 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | None | $645.65 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,630.78 | Facility | None | $512.86 | $2,238.72 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $1,000.00 | Professional | None | $616.60 | $645.65 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,000.00 | Professional | None | $630.96 | $691.83 | $1,000.00 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,570.40 | Facility | None | $758.58 | $1,412.54 | $2,570.40 |
United Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,348.96 | Professional | None | $588.84 | $676.08 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $977.24 | Professional | None | $537.03 | $537.03 | $977.24 |
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 $407.38 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $616.60 |
Where Maryland sits
The same service costs 8.5 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· 44th of 51
$708
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.