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 $389.05 Median $398.11 Typical High $426.58 | Professional | None | $389.05 | $398.11 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $18,620.87 Typical High $30,902.95 | Facility | None | $512.86 | $18,620.87 | $30,902.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $707.95 | Professional | None | $363.08 | $416.87 | $707.95 |
United Setting Facility Modifier None Typical Low $12,589.25 Median $20,417.38 Typical High $30,902.95 | Facility | None | $12,589.25 | $20,417.38 | $30,902.95 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $1,023.29 | Professional | None | $363.08 | $549.54 | $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 $194.98 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $288.40 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $42.66 |
Where Maryland sits
The same service costs 57.5 times more in Arkansas than in New York. 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· 7th of 51
$8,710
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.