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 $812.83 Median $831.76 Typical High $977.24 | Professional | None | $812.83 | $831.76 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,000.00 | Professional | None | $741.31 | $812.83 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $17,378.01 Typical High $29,512.09 | Facility | None | $331.13 | $17,378.01 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $2,290.87 | Professional | None | $741.31 | $891.25 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,479.11 | Professional | None | $724.44 | $831.76 | $1,479.11 |
United Setting Facility Modifier None Typical Low $4,786.30 Median $10,715.19 Typical High $14,791.08 | Facility | None | $4,786.30 | $10,715.19 | $14,791.08 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,862.09 | Professional | None | $707.95 | $1,071.52 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,096.48 | Professional | None | $645.65 | $645.65 | $1,096.48 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $602.56 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $575.44 |
Where Maryland sits
The same service costs 13.5 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
$955
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.