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 $1,122.02 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,148.15 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,090.30 Typical High $5,011.87 | Facility | None | $707.95 | $3,090.30 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,818.38 | Professional | None | $977.24 | $1,174.90 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,202.26 | $1,949.84 |
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 $912.01 Median $1,348.96 Typical High $2,691.53 | Professional | None | $912.01 | $1,348.96 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,584.89 | Professional | None | $933.25 | $933.25 | $1,584.89 |
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 $562.34 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $831.76 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $177.83 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $831.76 |
Where Maryland sits
The same service costs 6.8 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· 40th of 51
$1,202
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.