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 $446.68 Median $457.09 Typical High $489.78 | Professional | None | $446.68 | $457.09 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $537.03 | Professional | None | $416.87 | $467.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $5,495.41 | Facility | None | $1,348.96 | $3,090.30 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,318.26 | Professional | None | $416.87 | $512.86 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $741.31 | Professional | None | $416.87 | $478.63 | $741.31 |
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 $380.19 Median $562.34 Typical High $1,122.02 | Professional | None | $380.19 | $562.34 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $630.96 | Professional | None | $338.84 | $338.84 | $630.96 |
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 $223.87 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $89.13 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $331.13 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $309.03 | $316.23 | $346.74 |
Where Maryland sits
The same service costs 9.5 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· 36th of 51
$575
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.