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 $831.76 Median $977.24 Typical High $1,905.46 | Professional | None | $831.76 | $977.24 | $1,905.46 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $954.99 | Professional | None | $758.58 | $851.14 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,621.81 Typical High $2,691.53 | Facility | None | $512.86 | $1,621.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,995.26 | Professional | None | $741.31 | $912.01 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,584.89 | Professional | None | $758.58 | $870.96 | $1,584.89 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,187.76 | Professional | None | $707.95 | $1,000.00 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,148.15 | Professional | None | $630.96 | $630.96 | $1,148.15 |
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 $436.52 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $676.08 |
Where Maryland sits
The same service costs 4.4 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· 45th of 51
$1,000
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.