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 $338.84 Median $346.74 Typical High $371.54 | Professional | None | $338.84 | $346.74 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,413.10 Typical High $12,302.69 | Facility | None | $512.86 | $7,413.10 | $12,302.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $676.08 | Professional | None | $389.05 | $436.52 | $676.08 |
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 $295.12 Median $436.52 Typical High $933.25 | Professional | None | $295.12 | $436.52 | $933.25 |
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 $169.82 Median $173.78 Typical High $186.21 | Professional | 52 · Reduced service | $169.82 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $67.61 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $251.19 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $37.15 |
Where Maryland sits
The same service costs 15.8 times more in Arkansas 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· 13th 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.