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 $218.78 Median $223.87 Typical High $239.88 | Professional | None | $218.78 | $223.87 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | None | $204.17 | $229.09 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $2,818.38 | Facility | None | $331.13 | $1,698.24 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $630.96 | Professional | None | $204.17 | $251.19 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $363.08 | Professional | None | $204.17 | $234.42 | $363.08 |
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 $186.21 Median $281.84 Typical High $549.54 | Professional | None | $186.21 | $281.84 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $309.03 | Professional | None | $165.96 | $165.96 | $309.03 |
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 $109.65 Median $112.20 Typical High $120.23 | Professional | 52 · Reduced service | $109.65 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $43.65 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $162.18 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.39 Typical High $23.99 | Professional | 56 · Pre-op care only | $21.88 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $151.36 | $154.88 | $169.82 |
Where Maryland sits
The same service costs 8.9 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· 39th of 51
$275
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.