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 $302.00 Median $316.23 Typical High $331.13 | Professional | None | $302.00 | $316.23 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $389.05 | Professional | None | $288.40 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,905.46 | Facility | None | $630.96 | $1,047.13 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $891.25 | Professional | None | $288.40 | $346.74 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $537.03 | Professional | None | $288.40 | $331.13 | $537.03 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $724.44 | Professional | None | $257.04 | $389.05 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $436.52 | Professional | None | $229.09 | $229.09 | $436.52 |
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 $154.88 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | 54 · Surgery only | $234.42 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $223.87 |
Where Maryland sits
The same service costs 5.4 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· 36th of 51
$407
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.