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 $501.19 Median $524.81 Typical High $588.84 | Professional | None | $501.19 | $524.81 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | None | $457.09 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,951.21 Typical High $5,011.87 | Facility | None | $446.68 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $1,174.90 | Professional | None | $436.52 | $512.86 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $870.96 | Professional | None | $478.63 | $549.54 | $870.96 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,122.02 | Professional | None | $398.11 | $588.84 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $724.44 | Professional | None | $346.74 | $346.74 | $724.44 |
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 $245.47 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $371.54 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $416.87 |
Where Maryland sits
The same service costs 10.0 times more in Oklahoma 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· 36th of 51
$589
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.