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 $457.09 Median $501.19 Typical High $512.86 | Professional | None | $457.09 | $501.19 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $489.78 | Professional | None | $389.05 | $426.58 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $2,041.74 | Facility | None | $446.68 | $1,148.15 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $1,071.52 | Professional | None | $389.05 | $467.74 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $794.33 | Professional | None | $380.19 | $436.52 | $794.33 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $1,148.15 | Professional | None | $371.54 | $549.54 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $575.44 | Professional | None | $331.13 | $331.13 | $575.44 |
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 $234.42 Median $251.19 Typical High $257.04 | Professional | 52 · Reduced service | $234.42 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $363.08 |
Where Maryland sits
The same service costs 6.3 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· 46th of 51
$513
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.