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 $794.33 Median $933.25 Typical High $954.99 | Professional | None | $794.33 | $933.25 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | None | $758.58 | $831.76 | $954.99 |
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 $707.95 Median $851.14 Typical High $1,949.84 | Professional | None | $707.95 | $851.14 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,479.11 | Professional | None | $707.95 | $812.83 | $1,479.11 |
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 $691.83 Median $977.24 Typical High $2,089.30 | Professional | None | $691.83 | $977.24 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,071.52 | Professional | None | $616.60 | $616.60 | $1,071.52 |
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 $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $660.69 |
Where Maryland sits
The same service costs 6.6 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· 40th of 51
$1,023
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.