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 $501.19 Median $537.03 Typical High $575.44 | Professional | None | $501.19 | $537.03 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | None | $457.09 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $20,417.38 Typical High $33,884.42 | Facility | None | $512.86 | $20,417.38 | $33,884.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $891.25 | Professional | None | $363.08 | $416.87 | $891.25 |
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 $630.96 Median $1,023.29 Typical High $1,819.70 | Professional | None | $630.96 | $1,023.29 | $1,819.70 |
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 $251.19 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $57.54 |
Where Maryland sits
The same service costs 50.1 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· 37th of 51
$1,148
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.