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 $954.99 | Professional | None | $812.83 | $933.25 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | None | $616.60 | $831.76 | $831.76 |
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 $645.65 Median $794.33 Typical High $1,698.24 | Professional | None | $645.65 | $794.33 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,513.56 | Professional | None | $812.83 | $912.01 | $1,513.56 |
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 $489.78 Median $812.83 Typical High $2,137.96 | Professional | None | $489.78 | $812.83 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,230.27 | Professional | None | $416.87 | $416.87 | $1,230.27 |
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 $467.74 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $165.96 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $141.25 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $93.33 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $660.69 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $660.69 | $676.08 |
Where Maryland sits
The same service costs 6.8 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· 41st 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.