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 $467.74 Median $1,318.26 Typical High $6,309.57 | Professional | None | $467.74 | $1,318.26 | $6,309.57 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | None | $457.09 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,715.35 Typical High $6,760.83 | Facility | None | $512.86 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,445.44 Typical High $8,912.51 | Professional | None | $446.68 | $1,445.44 | $8,912.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,165.95 Median $7,079.46 Typical High $12,589.25 | Professional | None | $6,165.95 | $7,079.46 | $12,589.25 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $3,801.89 Typical High $8,128.31 | Facility | None | $1,584.89 | $3,801.89 | $8,128.31 |
United Setting Professional Modifier None Typical Low $436.52 Median $4,466.84 Typical High $12,302.69 | Professional | None | $436.52 | $4,466.84 | $12,302.69 |
Wellpoint Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $9,772.37 | Professional | None | $5,623.41 | $5,623.41 | $9,772.37 |
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 $234.42 Median $331.13 Typical High $3,162.28 | Professional | 52 · Reduced service | $234.42 | $331.13 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $131.83 Typical High $1,258.93 | Professional | 53 · Discontinued | $93.33 | $131.83 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $489.78 Typical High $4,786.30 | Professional | 54 · Surgery only | $354.81 | $489.78 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $100.00 Typical High $954.99 | Professional | 55 · Aftercare only | $70.79 | $100.00 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $66.07 Typical High $630.96 | Professional | 56 · Pre-op care only | $46.77 | $66.07 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $457.09 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $331.13 | $457.09 | $4,466.84 |
Where Maryland sits
The same service costs 13.5 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
$1,047
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.