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 $213.80 Median $229.09 Typical High $257.04 | Professional | None | $213.80 | $229.09 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | None | $199.53 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $2,398.83 | Facility | None | $331.13 | $1,479.11 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $549.54 | Professional | None | $199.53 | $251.19 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $380.19 | Professional | None | $204.17 | $234.42 | $380.19 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $524.81 | Professional | None | $181.97 | $263.03 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $309.03 | Professional | None | $162.18 | $162.18 | $309.03 |
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 $112.20 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $44.67 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $169.82 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $158.49 | $162.18 | $181.97 |
Where Maryland sits
The same service costs 7.6 times more in Oklahoma than in New York. 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· 42nd of 51
$269
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.