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 $870.96 Median $891.25 Typical High $1,000.00 | Professional | None | $870.96 | $891.25 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,011.87 | Facility | None | $512.86 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $2,089.30 | Professional | None | $724.44 | $891.25 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,445.44 | Professional | None | $758.58 | $891.25 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $2,041.74 | Professional | None | $707.95 | $1,023.29 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,174.90 | Professional | None | $602.56 | $602.56 | $1,174.90 |
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 $436.52 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $691.83 |
Where Maryland sits
The same service costs 6.9 times more in Oklahoma than in Texas. 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· 37th of 51
$1,000
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.