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 $707.95 Median $776.25 Typical High $794.33 | Professional | None | $707.95 | $776.25 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | None | $676.08 | $741.31 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,691.53 Typical High $4,466.84 | Facility | None | $446.68 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $2,089.30 | Professional | None | $676.08 | $812.83 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,202.26 | Professional | None | $660.69 | $758.58 | $1,202.26 |
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 $616.60 Median $912.01 Typical High $1,819.70 | Professional | None | $616.60 | $912.01 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,000.00 | Professional | None | $549.54 | $549.54 | $1,000.00 |
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 $354.81 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $588.84 | Professional | 54 · Surgery only | $537.03 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $549.54 |
Where Maryland sits
The same service costs 6.3 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· 45th 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.