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 $398.11 Median $1,096.48 Typical High $1,995.26 | Professional | None | $398.11 | $1,096.48 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | None | $389.05 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $3,019.95 | Facility | None | $512.86 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,202.26 Typical High $2,454.71 | Professional | None | $380.19 | $1,202.26 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,862.09 | $2,137.96 | $3,548.13 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $3,890.45 | Facility | None | $954.99 | $2,089.30 | $3,890.45 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,230.27 Typical High $3,162.28 | Professional | None | $363.08 | $1,230.27 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,819.70 | $1,819.70 | $2,951.21 |
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 $199.53 Median $281.84 Typical High $1,000.00 | Professional | 52 · Reduced service | $199.53 | $281.84 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $112.20 Typical High $398.11 | Professional | 53 · Discontinued | $79.43 | $112.20 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $416.87 Typical High $1,479.11 | Professional | 54 · Surgery only | $295.12 | $416.87 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $83.18 Typical High $295.12 | Professional | 55 · Aftercare only | $58.88 | $83.18 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $56.23 Typical High $199.53 | Professional | 56 · Pre-op care only | $39.81 | $56.23 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $389.05 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $275.42 | $389.05 | $1,380.38 |
Where Maryland sits
The same service costs 5.2 times more in Oregon than in Kentucky. 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
$871
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.