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 $354.81 Median $380.19 Typical High $380.19 | Professional | None | $354.81 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,585.78 Typical High $12,882.50 | Facility | None | $512.86 | $7,585.78 | $12,882.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $724.44 | Professional | None | $371.54 | $426.58 | $724.44 |
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 $354.81 Median $562.34 Typical High $1,000.00 | Professional | None | $354.81 | $562.34 | $1,000.00 |
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 $177.83 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $38.02 |
Where Maryland sits
The same service costs 32.4 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· 14th 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.