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 $851.14 Median $851.14 Typical High $912.01 | Professional | None | $851.14 | $851.14 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $912.01 | Professional | None | $776.25 | $870.96 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,691.53 Typical High $4,466.84 | Facility | None | $512.86 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $2,398.83 | Professional | None | $776.25 | $933.25 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,380.38 | Professional | None | $758.58 | $870.96 | $1,380.38 |
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 $707.95 Median $1,047.13 Typical High $1,995.26 | Professional | None | $707.95 | $1,047.13 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,148.15 | Professional | None | $630.96 | $630.96 | $1,148.15 |
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 $426.58 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $426.58 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Maryland sits
The same service costs 6.0 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· 43rd of 51
$912
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.