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 $1,096.48 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,096.48 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | None | $851.14 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,818.38 | Facility | None | $512.86 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $1,202.26 | Professional | None | $831.76 | $851.14 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,288.25 | Professional | None | $812.83 | $891.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,778.28 | Professional | None | $660.69 | $851.14 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,230.27 | Professional | None | $724.44 | $724.44 | $1,230.27 |
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 $549.54 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $812.83 |
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· 41st of 51
$955
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.