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 $575.44 Typical High $616.60 | Professional | None | $537.03 | $575.44 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | None | $524.81 | $575.44 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $2,398.83 | Facility | None | $331.13 | $1,479.11 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,445.44 | Professional | None | $501.19 | $616.60 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $1,000.00 | Professional | None | $537.03 | $616.60 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,348.96 | Professional | None | $478.63 | $707.95 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $812.83 | Professional | None | $467.74 | $467.74 | $812.83 |
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 $288.40 Median $302.00 Typical High $309.03 | Professional | 52 · Reduced service | $288.40 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $114.82 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $426.58 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $426.58 |
Where Maryland sits
The same service costs 10.5 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· 41st of 51
$646
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.