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 $977.24 Median $1,071.52 Typical High $1,513.56 | Professional | None | $977.24 | $1,071.52 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,096.48 | Professional | None | $912.01 | $1,023.29 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,897.79 Typical High $8,128.31 | Facility | None | $512.86 | $4,897.79 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $2,818.38 | Professional | None | $912.01 | $1,096.48 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,778.28 | Professional | None | $891.25 | $1,023.29 | $1,778.28 |
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 $851.14 Median $1,258.93 Typical High $2,511.89 | Professional | None | $851.14 | $1,258.93 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,348.96 | Professional | None | $758.58 | $758.58 | $1,348.96 |
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 $489.78 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $489.78 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $194.98 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $758.58 |
Where Maryland sits
The same service costs 6.3 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· 45th of 51
$1,072
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.