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 $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $891.25 | Professional | None | $794.33 | $870.96 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $2,089.30 | Professional | None | $724.44 | $891.25 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,412.54 | Professional | None | $776.25 | $891.25 | $1,412.54 |
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 $691.83 Median $1,047.13 Typical High $1,995.26 | Professional | None | $691.83 | $1,047.13 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,174.90 | Professional | None | $724.44 | $724.44 | $1,174.90 |
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 $338.84 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $338.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $524.81 |
Where Maryland sits
The same service costs 6.3 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· 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.