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 $575.44 Median $776.25 Typical High $870.96 | Professional | None | $575.44 | $776.25 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $5,011.87 Typical High $8,511.38 | Facility | None | $512.86 | $5,011.87 | $8,511.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,148.15 | Professional | None | $758.58 | $870.96 | $1,148.15 |
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 $309.03 Median $489.78 Typical High $933.25 | Professional | None | $309.03 | $489.78 | $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 $288.40 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $288.40 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $436.52 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $87.10 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $77.62 | $87.10 |
Where Maryland sits
The same service costs 14.8 times more in Texas 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· 28th of 51
$1,072
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.