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 Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $524.81 | Professional | None | $467.74 | $501.19 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $562.34 | Professional | None | $446.68 | $489.78 | $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 $446.68 Median $537.03 Typical High $1,380.38 | Professional | None | $446.68 | $537.03 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $776.25 | Professional | None | $436.52 | $501.19 | $776.25 |
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 $407.38 Median $588.84 Typical High $1,174.90 | Professional | None | $407.38 | $588.84 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $660.69 | Professional | None | $363.08 | $363.08 | $660.69 |
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 $234.42 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $93.33 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $363.08 |
Where Maryland sits
The same service costs 8.7 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
$589
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.