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 $549.54 Median $602.56 Typical High $660.69 | Professional | None | $549.54 | $602.56 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $524.81 | Professional | None | $457.09 | $501.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $3,890.45 | Facility | None | $512.86 | $2,089.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,258.93 | Professional | None | $457.09 | $549.54 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $933.25 | Professional | None | $446.68 | $512.86 | $933.25 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $5,623.41 | Facility | None | $954.99 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,348.96 | Professional | None | $436.52 | $630.96 | $1,348.96 |
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 $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $426.58 |
Where Maryland sits
The same service costs 7.2 times more in Oklahoma than in Ohio. 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· 43rd of 51
$661
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.