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 $309.03 Median $309.03 Typical High $338.84 | Professional | None | $309.03 | $309.03 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | None | $354.81 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $2,818.38 | Facility | None | $331.13 | $1,698.24 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $891.25 | Professional | None | $316.23 | $380.19 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $630.96 | Professional | None | $338.84 | $389.05 | $630.96 |
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 $288.40 Median $426.58 Typical High $831.76 | Professional | None | $288.40 | $426.58 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $512.86 | Professional | None | $288.40 | $288.40 | $512.86 |
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 $154.88 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $154.88 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $61.66 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $229.09 |
Where Maryland sits
The same service costs 8.5 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· 41st of 51
$407
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.