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 $645.65 Median $676.08 Typical High $691.83 | Professional | None | $645.65 | $676.08 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | None | $616.60 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $5,011.87 | Facility | None | $630.96 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,949.84 | Professional | None | $616.60 | $758.58 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,096.48 | Professional | None | $602.56 | $691.83 | $1,096.48 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,584.89 | Professional | None | $562.34 | $851.14 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $912.01 | Professional | None | $512.86 | $512.86 | $912.01 |
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 $338.84 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $489.78 |
Where Maryland sits
The same service costs 7.2 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
$759
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.