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 $1,318.26 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,348.96 | $1,380.38 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,348.96 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $5,248.07 Typical High $8,317.64 | Facility | None | $1,348.96 | $5,248.07 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $3,801.89 | Professional | None | $1,230.27 | $1,479.11 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,348.96 | $2,187.76 |
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 $1,122.02 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,698.24 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,023.29 | $1,778.28 |
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 $676.08 Median $676.08 Typical High $691.83 | Professional | 52 · Reduced service | $676.08 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | 53 · Discontinued | $269.15 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $954.99 |
Where Maryland sits
The same service costs 6.8 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· 44th of 51
$1,479
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.