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 $741.31 Median $758.58 Typical High $812.83 | Professional | None | $741.31 | $758.58 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $794.33 | Professional | None | $691.83 | $776.25 | $794.33 |
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 $691.83 Median $851.14 Typical High $2,187.76 | Professional | None | $691.83 | $851.14 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,230.27 | Professional | None | $676.08 | $776.25 | $1,230.27 |
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 $630.96 Median $954.99 Typical High $1,862.09 | Professional | None | $630.96 | $954.99 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,023.29 | Professional | None | $575.44 | $575.44 | $1,023.29 |
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 $371.54 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $575.44 |
Where Maryland sits
The same service costs 8.7 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
$832
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.