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 $758.58 Median $794.33 Typical High $812.83 | Professional | None | $758.58 | $794.33 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
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 $758.58 Median $954.99 Typical High $2,041.74 | Professional | None | $758.58 | $954.99 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,445.44 | Professional | None | $794.33 | $891.25 | $1,445.44 |
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 $724.44 Median $1,071.52 Typical High $2,041.74 | Professional | None | $724.44 | $1,071.52 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | None | $776.25 | $776.25 | $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 $380.19 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $575.44 |
Where Maryland sits
The same service costs 8.5 times more in Oklahoma than in Texas. 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· 42nd of 51
$933
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.