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 $549.54 Median $562.34 Typical High $602.56 | Professional | None | $549.54 | $562.34 | $602.56 |
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 $331.13 Median $380.19 Typical High $758.58 | Professional | None | $331.13 | $380.19 | $758.58 |
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 $446.68 Median $776.25 Typical High $1,258.93 | Professional | None | $446.68 | $776.25 | $1,258.93 |
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 $275.42 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $60.26 |
Where Maryland sits
The same service costs 10.2 times more in Texas 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· 25th of 51
$1,202
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.