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 $588.84 Median $616.60 Typical High $630.96 | Professional | None | $588.84 | $616.60 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $812.83 | Professional | None | $602.56 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,290.87 Typical High $3,801.89 | Facility | None | $512.86 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,778.28 | Professional | None | $575.44 | $691.83 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,071.52 | Professional | None | $562.34 | $645.65 | $1,071.52 |
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 $512.86 Median $776.25 Typical High $1,445.44 | Professional | None | $512.86 | $776.25 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $851.14 | Professional | None | $467.74 | $467.74 | $851.14 |
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 $309.03 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $446.68 |
Where Maryland sits
The same service costs 9.8 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· 41st of 51
$724
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.