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 $239.88 Median $239.88 Typical High $257.04 | Professional | None | $239.88 | $239.88 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $3,467.37 | Facility | None | $512.86 | $2,089.30 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $478.63 | Professional | None | $263.03 | $302.00 | $478.63 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $645.65 | Professional | None | $208.93 | $309.03 | $645.65 |
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 $120.23 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $47.86 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $177.83 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $25.70 |
Where Maryland sits
The same service costs 10.7 times more in Colorado 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· 20th of 51
$955
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.