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 $575.44 Median $616.60 Typical High $660.69 | Professional | None | $575.44 | $616.60 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $812.83 | Professional | None | $707.95 | $794.33 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $3,162.28 | Facility | None | $630.96 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,737.80 | Professional | None | $549.54 | $676.08 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,000.00 | Professional | None | $537.03 | $630.96 | $1,000.00 |
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 $616.60 Median $1,000.00 Typical High $1,819.70 | Professional | None | $616.60 | $1,000.00 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $288.40 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $416.87 | $457.09 |
Where Maryland sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 46th of 51
$794
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.