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 $524.81 Median $537.03 Typical High $707.95 | Professional | None | $524.81 | $537.03 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | None | $489.78 | $537.03 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,818.38 | Facility | None | $512.86 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $1,479.11 | Professional | None | $478.63 | $575.44 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $851.14 | Professional | None | $371.54 | $426.58 | $851.14 |
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 $436.52 Median $645.65 Typical High $1,202.26 | Professional | None | $436.52 | $645.65 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $562.34 | Professional | None | $371.54 | $371.54 | $562.34 |
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 $263.03 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $380.19 |
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· 45th of 51
$562
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.