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 $181.97 Median $194.98 Typical High $208.93 | Professional | None | $181.97 | $194.98 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | None | $173.78 | $190.55 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $676.08 | Facility | None | $83.18 | $138.04 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $512.86 | Professional | None | $173.78 | $213.80 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $371.54 | Professional | None | $204.17 | $234.42 | $371.54 |
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 $154.88 Median $239.88 Typical High $457.09 | Professional | None | $154.88 | $239.88 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $309.03 | Professional | None | $147.91 | $147.91 | $309.03 |
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 $91.20 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $36.31 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $134.90 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $125.89 | $128.82 | $147.91 |
Where Maryland sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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
$209
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.