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 $61.66 Median $331.13 Typical High $354.81 | Professional | None | $61.66 | $331.13 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,918.31 Typical High $11,748.98 | Facility | None | $512.86 | $6,918.31 | $11,748.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $549.54 | Professional | None | $309.03 | $398.11 | $549.54 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $1,023.29 | Professional | None | $45.71 | $74.13 | $1,023.29 |
5 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 $30.90 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $30.90 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $12.30 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $251.19 Typical High $269.15 | Professional | 54 · Surgery only | $46.77 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $9.33 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $6.17 | $33.11 | $35.48 |
Where Maryland sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 17th of 51
$2,692
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.