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 $1,174.90 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,202.26 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
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 $1,023.29 Median $1,230.27 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,230.27 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,230.27 | $1,949.84 |
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 $954.99 Median $1,445.44 Typical High $2,818.38 | Professional | None | $954.99 | $1,445.44 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,621.81 | Professional | None | $912.01 | $912.01 | $1,621.81 |
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 $588.84 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $933.25 |
Where Maryland sits
The same service costs 6.6 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
$1,349
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.