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 $245.47 Median $245.47 Typical High $288.40 | Professional | None | $245.47 | $245.47 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $338.84 | Professional | None | $295.12 | $331.13 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,818.38 | Facility | None | $512.86 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $741.31 | Professional | None | $263.03 | $331.13 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $512.86 | Professional | None | $269.15 | $309.03 | $512.86 |
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 $251.19 Median $371.54 Typical High $707.95 | Professional | None | $251.19 | $371.54 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $407.38 | Professional | None | $269.15 | $269.15 | $407.38 |
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 $120.23 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $48.98 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $204.17 | Professional | 54 · Surgery only | $181.97 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $173.78 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $169.82 | $173.78 | $190.55 |
Where Maryland sits
The same service costs 6.0 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
$380
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.