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 $776.25 Median $831.76 Typical High $1,000.00 | Professional | None | $776.25 | $831.76 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | None | $602.56 | $676.08 | $676.08 |
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 $588.84 Median $691.83 Typical High $870.96 | Professional | None | $588.84 | $691.83 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,230.27 | Professional | None | $794.33 | $891.25 | $1,230.27 |
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 $489.78 Median $616.60 Typical High $1,288.25 | Professional | None | $489.78 | $616.60 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,288.25 | Professional | None | $512.86 | $512.86 | $1,288.25 |
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 $389.05 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $154.88 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $588.84 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $707.95 |
Where Maryland sits
The same service costs 5.0 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· 44th of 51
$724
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.