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 $537.03 Median $562.34 Typical High $912.01 | Professional | None | $537.03 | $562.34 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | None | $489.78 | $537.03 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $28,183.83 Typical High $50,118.72 | Facility | None | $446.68 | $28,183.83 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,380.38 | Professional | None | $501.19 | $616.60 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $954.99 | Professional | None | $602.56 | $691.83 | $954.99 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $13,803.84 Typical High $20,417.38 | Facility | None | $7,585.78 | $13,803.84 | $20,417.38 |
United Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,348.96 | Professional | None | $467.74 | $707.95 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $912.01 | Professional | None | $562.34 | $562.34 | $912.01 |
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 $269.15 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $389.05 |
Where Maryland sits
The same service costs 20.0 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
$692
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.