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 $208.93 Median $223.87 Typical High $223.87 | Professional | None | $208.93 | $223.87 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $2,691.53 | Facility | None | $512.86 | $1,479.11 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $389.05 | Professional | None | $269.15 | $309.03 | $389.05 |
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 $181.97 Median $281.84 Typical High $537.03 | Professional | None | $181.97 | $281.84 | $537.03 |
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 $104.71 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $22.39 |
Where Maryland sits
The same service costs 19.5 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· 13th of 51
$631
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.