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 $933.25 Median $977.24 Typical High $1,000.00 | Professional | None | $933.25 | $977.24 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,047.13 | Professional | None | $933.25 | $1,023.29 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,011.87 Typical High $8,317.64 | Facility | None | $707.95 | $5,011.87 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,754.23 | Professional | None | $891.25 | $1,071.52 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,584.89 | Professional | None | $870.96 | $977.24 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $2,290.87 | Professional | None | $812.83 | $1,230.27 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,288.25 | Professional | None | $724.44 | $724.44 | $1,288.25 |
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 $489.78 Median $489.78 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $691.83 |
Where Maryland sits
The same service costs 8.3 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· 40th of 51
$1,072
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.