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 $154.88 Median $154.88 Typical High $181.97 | Professional | None | $154.88 | $154.88 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | None | $177.83 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,258.93 Typical High $2,290.87 | Facility | None | $512.86 | $1,258.93 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $467.74 | Professional | None | $165.96 | $208.93 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $316.23 | Professional | None | $169.82 | $194.98 | $316.23 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $436.52 | Professional | None | $154.88 | $229.09 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $257.04 | Professional | None | $162.18 | $162.18 | $257.04 |
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 $77.62 Median $77.62 Typical High $83.18 | Professional | 52 · Reduced service | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | 53 · Discontinued | $30.90 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $117.49 Typical High $125.89 | Professional | 54 · Surgery only | $114.82 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $25.12 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $109.65 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $107.15 | $109.65 | $117.49 |
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
$229
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.