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 $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | None | $446.68 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,737.80 Typical High $2,818.38 | Facility | None | $446.68 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,174.90 | Professional | None | $416.87 | $512.86 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $812.83 | Professional | None | $436.52 | $501.19 | $812.83 |
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 $389.05 Median $588.84 Typical High $1,122.02 | Professional | None | $389.05 | $588.84 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $660.69 | Professional | None | $407.38 | $407.38 | $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 $194.98 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $288.40 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $269.15 | $275.42 | $295.12 |
Where Maryland sits
The same service costs 8.9 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· 42nd of 51
$513
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.