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 $1,258.93 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,348.96 | $2,691.53 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,380.38 | $1,412.54 |
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 $1,202.26 Median $1,445.44 Typical High $3,715.35 | Professional | None | $1,202.26 | $1,445.44 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,318.26 | $2,137.96 |
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 $1,096.48 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,096.48 | $1,659.59 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,000.00 | $1,737.80 |
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 $660.69 Median $660.69 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 53 · Discontinued | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $933.25 |
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· 46th 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.