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 $549.54 Median $588.84 Typical High $758.58 | Professional | None | $549.54 | $588.84 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | None | $426.58 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $1,949.84 | Facility | None | $446.68 | $1,096.48 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $676.08 | Professional | None | $416.87 | $512.86 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $933.25 | Professional | None | $588.84 | $676.08 | $933.25 |
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 $363.08 Median $478.63 Typical High $933.25 | Professional | None | $363.08 | $478.63 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $977.24 | Professional | None | $363.08 | $363.08 | $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 $275.42 Median $295.12 Typical High $380.19 | Professional | 52 · Reduced service | $275.42 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $151.36 | Professional | 53 · Discontinued | $109.65 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $575.44 | Professional | 54 · Surgery only | $416.87 | $436.52 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $114.82 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $537.03 |
Where Maryland sits
The same service costs 5.6 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· 45th of 51
$550
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.