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 $524.81 Median $562.34 Typical High $562.34 | Professional | None | $524.81 | $562.34 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $562.34 | Professional | None | $478.63 | $537.03 | $562.34 |
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 $478.63 Median $575.44 Typical High $1,479.11 | Professional | None | $478.63 | $575.44 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $851.14 | Professional | None | $478.63 | $549.54 | $851.14 |
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 $436.52 Median $645.65 Typical High $1,288.25 | Professional | None | $436.52 | $645.65 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $724.44 | Professional | None | $398.11 | $398.11 | $724.44 |
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 $251.19 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $380.19 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $398.11 |
Where Maryland sits
The same service costs 10.0 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· 39th of 51
$631
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.