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 $204.17 Median $229.09 Typical High $489.78 | Professional | None | $204.17 | $229.09 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $295.12 | Professional | None | $218.78 | $245.47 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $3,162.28 | Facility | None | $707.95 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $588.84 | Professional | None | $213.80 | $269.15 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $446.68 | Professional | None | $263.03 | $302.00 | $446.68 |
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 $199.53 Median $302.00 Typical High $575.44 | Professional | None | $199.53 | $302.00 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $537.03 | Professional | None | $295.12 | $398.11 | $537.03 |
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 $102.33 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $102.33 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $40.74 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $169.82 Typical High $190.55 | Professional | 54 · Surgery only | $154.88 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $158.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $144.54 | $158.49 | $177.83 |
Where Maryland sits
The same service costs 4.6 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· 29th of 51
$309
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.