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 $660.69 Median $707.95 Typical High $707.95 | Professional | None | $660.69 | $707.95 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | None | $602.56 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,737.80 Typical High $2,818.38 | Facility | None | $446.68 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,905.46 | Professional | None | $602.56 | $741.31 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,071.52 | Professional | None | $602.56 | $691.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,621.81 | Professional | None | $549.54 | $812.83 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $912.01 | Professional | None | $501.19 | $501.19 | $912.01 |
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 $323.59 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $323.59 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $501.19 |
Where Maryland sits
The same service costs 8.5 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· 44th of 51
$741
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.