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 $630.96 Median $645.65 Typical High $741.31 | Professional | None | $630.96 | $645.65 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $933.25 | Professional | None | $794.33 | $870.96 | $933.25 |
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 $691.83 Median $851.14 Typical High $1,949.84 | Professional | None | $691.83 | $851.14 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,318.26 | Professional | None | $724.44 | $831.76 | $1,318.26 |
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 $676.08 Median $977.24 Typical High $1,862.09 | Professional | None | $676.08 | $977.24 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,096.48 | Professional | None | $724.44 | $724.44 | $1,096.48 |
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 $316.23 Median $323.59 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $524.81 |
Where Maryland sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 43rd of 51
$871
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.