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 $407.38 Median $416.87 Typical High $512.86 | Professional | None | $407.38 | $416.87 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $549.54 | Professional | None | $489.78 | $537.03 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,162.28 Typical High $5,248.07 | Facility | None | $512.86 | $3,162.28 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $1,258.93 | Professional | None | $446.68 | $549.54 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $851.14 | Professional | None | $467.74 | $549.54 | $851.14 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $1,202.26 | Professional | None | $426.58 | $630.96 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
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 $204.17 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $331.13 |
Where Maryland sits
The same service costs 11.2 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· 39th of 51
$589
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.