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 $380.19 Median $416.87 Typical High $426.58 | Professional | None | $380.19 | $416.87 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | None | $316.23 | $354.81 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,943.28 Typical High $14,125.38 | Facility | None | $512.86 | $7,943.28 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $870.96 | Professional | None | $316.23 | $380.19 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $691.83 | Professional | None | $316.23 | $363.08 | $691.83 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,762.47 Typical High $19,952.62 | Facility | None | $3,019.95 | $7,762.47 | $19,952.62 |
United Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $933.25 | Professional | None | $316.23 | $467.74 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $478.63 | Professional | None | $288.40 | $288.40 | $478.63 |
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 $204.17 Median $208.93 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $281.84 | $288.40 | $295.12 |
Where Maryland sits
The same service costs 18.6 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· 37th of 51
$537
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.