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 $436.52 Median $467.74 Typical High $602.56 | Professional | None | $436.52 | $467.74 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | None | $346.74 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,122.02 Typical High $2,089.30 | Facility | None | $512.86 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $537.03 | Professional | None | $331.13 | $416.87 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $741.31 | Professional | None | $478.63 | $537.03 | $741.31 |
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 $281.84 Median $371.54 Typical High $741.31 | Professional | None | $281.84 | $371.54 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $776.25 | Professional | None | $288.40 | $288.40 | $776.25 |
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 $218.78 Median $234.42 Typical High $302.00 | Professional | 52 · Reduced service | $218.78 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $120.23 | Professional | 53 · Discontinued | $87.10 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $457.09 | Professional | 54 · Surgery only | $331.13 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $91.20 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $60.26 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $426.58 |
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· 43rd of 51
$437
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.