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 $1,122.02 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,174.90 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,202.26 | Professional | None | $954.99 | $1,071.52 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $5,248.07 | Facility | None | $512.86 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,511.89 | Professional | None | $891.25 | $1,096.48 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,905.46 | Professional | None | $891.25 | $1,047.13 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,630.27 | Professional | None | $891.25 | $1,230.27 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,380.38 | Professional | None | $812.83 | $812.83 | $1,380.38 |
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 $549.54 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $831.76 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $831.76 |
Where Maryland sits
The same service costs 5.1 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· 41st of 51
$1,288
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.