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 $1,202.26 Median $1,230.27 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,230.27 | $2,398.83 |
CareFirst Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,202.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,897.79 Typical High $8,128.31 | Facility | None | $512.86 | $4,897.79 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $3,388.44 | Professional | None | $1,096.48 | $1,380.38 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,202.26 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $5,754.40 | Facility | None | $1,348.96 | $2,570.40 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,659.59 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,023.29 | $1,584.89 |
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 $588.84 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $128.82 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $912.01 |
Where Maryland sits
The same service costs 5.8 times more in Oklahoma than in Utah. 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· 43rd of 51
$1,413
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.