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 $1,148.15 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,174.90 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,000.00 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,818.38 | Professional | None | $1,000.00 | $1,230.27 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,174.90 | $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 $954.99 Median $1,412.54 Typical High $2,691.53 | Professional | None | $954.99 | $1,412.54 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,548.82 | Professional | None | $954.99 | $954.99 | $1,548.82 |
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 $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $562.34 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $851.14 |
Where Maryland sits
The same service costs 6.6 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· 42nd of 51
$1,259
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.