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 $812.83 Median $870.96 Typical High $933.25 | Professional | None | $812.83 | $870.96 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | None | $794.33 | $870.96 | $870.96 |
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 $758.58 Median $954.99 Typical High $2,187.76 | Professional | None | $758.58 | $954.99 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,513.56 | Professional | None | $794.33 | $912.01 | $1,513.56 |
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 $741.31 Median $1,122.02 Typical High $2,089.30 | Professional | None | $741.31 | $1,122.02 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Professional | None | $758.58 | $758.58 | $1,202.26 |
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 $436.52 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $645.65 |
Where Maryland sits
The same service costs 6.9 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· 41st of 51
$955
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.