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 $389.05 Median $416.87 Typical High $426.58 | Professional | None | $389.05 | $416.87 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $380.19 | Professional | None | $316.23 | $354.81 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,456.54 Typical High $11,748.98 | Facility | None | $512.86 | $6,456.54 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $870.96 | Professional | None | $323.59 | $389.05 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $660.69 | Professional | None | $316.23 | $363.08 | $660.69 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,762.47 Typical High $17,378.01 | Facility | None | $3,019.95 | $7,762.47 | $17,378.01 |
United Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $933.25 | Professional | None | $309.03 | $457.09 | $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 $190.55 Median $208.93 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $302.00 |
Where Maryland sits
The same service costs 21.4 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· 38th of 51
$525
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.