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 $512.86 Median $537.03 Typical High $562.34 | Professional | None | $512.86 | $537.03 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,762.47 Typical High $12,882.50 | Facility | None | $512.86 | $7,762.47 | $12,882.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $977.24 | Professional | None | $467.74 | $524.81 | $977.24 |
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 $457.09 Median $676.08 Typical High $1,288.25 | Professional | None | $457.09 | $676.08 | $1,288.25 |
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 $257.04 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $257.04 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $56.23 |
Where Maryland sits
The same service costs 24.0 times more in Arkansas 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· 8th 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.