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 $125.89 Median $162.18 Typical High $181.97 | Professional | None | $125.89 | $162.18 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $177.83 | Professional | None | $144.54 | $162.18 | $177.83 |
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 $138.04 Median $194.98 Typical High $457.09 | Professional | None | $138.04 | $194.98 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $354.81 | Professional | None | $208.93 | $245.47 | $354.81 |
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 $125.89 Median $204.17 Typical High $380.19 | Professional | None | $125.89 | $204.17 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $323.59 | Professional | None | $141.25 | $141.25 | $323.59 |
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 $63.10 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $25.12 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $93.33 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $109.65 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $87.10 | $109.65 | $125.89 |
Where Maryland sits
The same service costs 5.6 times more in Oklahoma than in Kentucky. 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· 38th of 51
$204
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.