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 $436.52 Median $467.74 Typical High $467.74 | Professional | None | $436.52 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $14,454.40 Typical High $24,547.09 | Facility | None | $512.86 | $14,454.40 | $24,547.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $977.24 | Professional | None | $457.09 | $524.81 | $977.24 |
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 $501.19 Median $831.76 Typical High $1,445.44 | Professional | None | $501.19 | $831.76 | $1,445.44 |
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 $218.78 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $331.13 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $46.77 |
Where Maryland sits
The same service costs 27.5 times more in Oklahoma 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· 17th 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.