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 $223.87 Median $257.04 Typical High $323.59 | Professional | None | $223.87 | $257.04 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | None | $208.93 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,258.93 Typical High $2,041.74 | Facility | None | $331.13 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $660.69 | Professional | None | $223.87 | $295.12 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $501.19 | Professional | None | $302.00 | $354.81 | $501.19 |
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 $199.53 Median $331.13 Typical High $645.65 | Professional | None | $199.53 | $331.13 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $467.74 | Professional | None | $218.78 | $218.78 | $467.74 |
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 $112.20 Median $125.89 Typical High $162.18 | Professional | 52 · Reduced service | $112.20 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $64.57 | Professional | 53 · Discontinued | $44.67 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $169.82 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $48.98 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $32.36 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $158.49 | $173.78 | $229.09 |
Where Maryland sits
The same service costs 4.5 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· 38th of 51
$324
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.