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 $147.91 Median $162.18 Typical High $239.88 | Professional | None | $147.91 | $162.18 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | None | $144.54 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,691.53 | Facility | None | $512.86 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $389.05 | Professional | None | $144.54 | $181.97 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $269.15 | Professional | None | $147.91 | $169.82 | $269.15 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $380.19 | Professional | None | $131.83 | $199.53 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $223.87 | Professional | None | $138.04 | $138.04 | $223.87 |
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 $79.43 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $79.43 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $31.62 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $123.03 Typical High $125.89 | Professional | 54 · Surgery only | $117.49 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $25.12 | Professional | 55 · Aftercare only | $23.99 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $114.82 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $112.20 | $114.82 | $117.49 |
Where Maryland sits
The same service costs 8.7 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· 36th of 51
$200
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.