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 $489.78 Median $501.19 Typical High $524.81 | Professional | None | $489.78 | $501.19 | $524.81 |
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 $676.08 Median $776.25 Typical High $1,023.29 | Professional | None | $676.08 | $776.25 | $1,023.29 |
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 $446.68 Median $676.08 Typical High $1,412.54 | Professional | None | $446.68 | $676.08 | $1,412.54 |
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 $245.47 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $245.47 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $371.54 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $52.48 |
Where Maryland sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 10th of 51
$4,074
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.