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 $912.01 Typical High $1,023.29 | Professional | None | $870.96 | $912.01 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | None | $776.25 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $5,011.87 | Facility | None | $630.96 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $2,137.96 | Professional | None | $758.58 | $912.01 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,479.11 | Professional | None | $794.33 | $933.25 | $1,479.11 |
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 $1,047.13 Typical High $1,995.26 | Professional | None | $707.95 | $1,047.13 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,230.27 | Professional | None | $616.60 | $616.60 | $1,230.27 |
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 $457.09 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $707.95 |
Where Maryland sits
The same service costs 7.4 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
$1,023
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.