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 $1,258.93 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,258.93 | $2,137.96 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,122.02 | $1,122.02 |
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 $933.25 Median $1,148.15 Typical High $2,630.27 | Professional | None | $933.25 | $1,148.15 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,995.26 | Professional | None | $954.99 | $1,096.48 | $1,995.26 |
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 $933.25 Median $1,318.26 Typical High $2,754.23 | Professional | None | $933.25 | $1,318.26 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,445.44 | Professional | None | $831.76 | $831.76 | $1,445.44 |
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 $575.44 Median $616.60 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $870.96 |
Where Maryland sits
The same service costs 5.8 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
$1,349
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.