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 $524.81 Median $602.56 Typical High $1,202.26 | Professional | None | $524.81 | $602.56 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $537.03 | Professional | None | $446.68 | $501.19 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,585.78 Typical High $13,803.84 | Facility | None | $512.86 | $7,585.78 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $1,230.27 | Professional | None | $446.68 | $537.03 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $933.25 | Professional | None | $436.52 | $501.19 | $933.25 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,762.47 Typical High $19,498.45 | Facility | None | $3,019.95 | $7,762.47 | $19,498.45 |
United Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,318.26 | Professional | None | $436.52 | $630.96 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $676.08 | Professional | None | $389.05 | $389.05 | $676.08 |
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 $275.42 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $416.87 |
Where Maryland sits
The same service costs 12.6 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
$676
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.