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 $331.13 Median $380.19 Typical High $389.05 | Professional | None | $331.13 | $380.19 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | None | $288.40 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $2,884.03 | Facility | None | $512.86 | $1,659.59 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $794.33 | Professional | None | $295.12 | $354.81 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $602.56 | Professional | None | $288.40 | $331.13 | $602.56 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $851.14 | Professional | None | $281.84 | $398.11 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $436.52 | Professional | None | $251.19 | $251.19 | $436.52 |
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 $177.83 Median $190.55 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $295.12 | Professional | 54 · Surgery only | $263.03 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $58.88 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $275.42 |
Where Maryland sits
The same service costs 7.4 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· 36th of 51
$501
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.