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 $363.08 Median $363.08 Typical High $426.58 | Professional | None | $363.08 | $363.08 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $512.86 | Professional | None | $416.87 | $467.74 | $512.86 |
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 $389.05 Median $489.78 Typical High $1,122.02 | Professional | None | $389.05 | $489.78 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $758.58 | Professional | None | $407.38 | $467.74 | $758.58 |
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 $363.08 Median $549.54 Typical High $1,047.13 | Professional | None | $363.08 | $549.54 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $616.60 | Professional | None | $380.19 | $380.19 | $616.60 |
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 $181.97 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $72.44 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | 54 · Surgery only | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $281.84 |
Where Maryland sits
The same service costs 10.2 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
$525
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.