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 $691.83 Median $758.58 Typical High $776.25 | Professional | None | $691.83 | $758.58 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $758.58 | Professional | None | $660.69 | $741.31 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $3,162.28 | Facility | None | $512.86 | $1,737.80 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $2,041.74 | Professional | None | $660.69 | $794.33 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,174.90 | Professional | None | $645.65 | $741.31 | $1,174.90 |
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 $602.56 Median $912.01 Typical High $1,819.70 | Professional | None | $602.56 | $912.01 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $977.24 | Professional | None | $588.84 | $588.84 | $977.24 |
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 $346.74 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $138.04 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $549.54 |
Where Maryland sits
The same service costs 6.5 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· 45th of 51
$776
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.