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 $870.96 Median $870.96 Typical High $891.25 | Professional | None | $870.96 | $870.96 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $954.99 | Professional | None | $851.14 | $933.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $2,511.89 | Professional | None | $794.33 | $977.24 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,412.54 | Professional | None | $776.25 | $891.25 | $1,412.54 |
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 $741.31 Median $1,071.52 Typical High $2,041.74 | Professional | None | $741.31 | $1,071.52 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,174.90 | Professional | None | $676.08 | $676.08 | $1,174.90 |
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 $436.52 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $630.96 |
Where Maryland sits
The same service costs 6.2 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· 40th of 51
$933
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.