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 $478.63 Median $478.63 Typical High $549.54 | Professional | None | $478.63 | $478.63 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $645.65 | Professional | None | $549.54 | $616.60 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,344.23 Typical High $3,801.89 | Facility | None | $512.86 | $2,344.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,445.44 | Professional | None | $512.86 | $630.96 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $977.24 | Professional | None | $524.81 | $602.56 | $977.24 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,380.38 | Professional | None | $489.78 | $724.44 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $794.33 | Professional | None | $524.81 | $524.81 | $794.33 |
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 $239.88 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $389.05 |
Where Maryland sits
The same service costs 7.9 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
$646
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.