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 $812.83 Median $933.25 Typical High $1,380.38 | Professional | None | $812.83 | $933.25 | $1,380.38 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | None | $707.95 | $794.33 | $794.33 |
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 $676.08 Median $831.76 Typical High $1,862.09 | Professional | None | $676.08 | $831.76 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,445.44 | Professional | None | $691.83 | $776.25 | $1,445.44 |
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 $457.09 Median $794.33 Typical High $2,041.74 | Professional | None | $457.09 | $794.33 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,047.13 | Professional | None | $575.44 | $575.44 | $1,047.13 |
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 $407.38 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $645.65 |
Where Maryland sits
The same service costs 7.6 times more in Oklahoma than in Kentucky. 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
$955
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.