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 $676.08 Median $794.33 Typical High $870.96 | Professional | None | $676.08 | $794.33 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $691.83 | Professional | None | $602.56 | $660.69 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $3,801.89 | Facility | None | $512.86 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,659.59 | Professional | None | $602.56 | $724.44 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,258.93 | Professional | None | $588.84 | $676.08 | $1,258.93 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $5,495.41 | Facility | None | $954.99 | $1,995.26 | $5,495.41 |
United Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,778.28 | Professional | None | $575.44 | $812.83 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $912.01 | Professional | None | $512.86 | $512.86 | $912.01 |
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 $363.08 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $562.34 |
Where Maryland sits
The same service costs 6.9 times more in Oklahoma than in Texas. 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· 42nd of 51
$851
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.