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 $776.25 Median $851.14 Typical High $1,047.13 | Professional | None | $776.25 | $851.14 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $851.14 | Professional | None | $724.44 | $812.83 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,090.30 Typical High $5,011.87 | Facility | None | $707.95 | $3,090.30 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $2,290.87 | Professional | None | $741.31 | $891.25 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,288.25 | Professional | None | $707.95 | $812.83 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,995.26 | Professional | None | $676.08 | $1,000.00 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,071.52 | Professional | None | $645.65 | $645.65 | $1,071.52 |
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 $389.05 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $602.56 |
Where Maryland sits
The same service costs 7.2 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· 43rd of 51
$891
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.