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 $380.19 Median $380.19 Typical High $389.05 | Professional | None | $380.19 | $380.19 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $2,041.74 | Facility | None | $512.86 | $1,148.15 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $776.25 | Professional | None | $371.54 | $426.58 | $776.25 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $1,071.52 | Professional | None | $363.08 | $602.56 | $1,071.52 |
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 $190.55 Median $190.55 Typical High $194.98 | Professional | 52 · Reduced service | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.90 |
Where Maryland sits
The same service costs 8.1 times more in Texas 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· 39th of 51
$646
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.