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 $1,000.00 Median $1,023.29 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,023.29 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $3,162.28 | Professional | None | $1,023.29 | $1,202.26 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,148.15 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,511.89 | Professional | None | $912.01 | $1,380.38 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,513.56 | Professional | None | $891.25 | $891.25 | $1,513.56 |
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 $501.19 Median $512.86 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $204.17 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $794.33 |
Where Maryland sits
The same service costs 8.9 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· 43rd of 51
$1,288
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.