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 $562.34 Typical High $851.14 | Professional | None | $501.19 | $562.34 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $537.03 | Professional | None | $426.58 | $478.63 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,413.10 Typical High $13,182.57 | Facility | None | $512.86 | $7,413.10 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $1,174.90 | Professional | None | $426.58 | $512.86 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $891.25 | Professional | None | $416.87 | $478.63 | $891.25 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,762.47 Typical High $19,054.61 | Facility | None | $3,019.95 | $7,762.47 | $19,054.61 |
United Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $1,258.93 | Professional | None | $407.38 | $575.44 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $645.65 | Professional | None | $363.08 | $363.08 | $645.65 |
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 $257.04 Median $281.84 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $398.11 |
Where Maryland sits
The same service costs 16.6 times more in Oklahoma than in Ohio. 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· 40th of 51
$646
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.