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 $363.08 Median $363.08 Typical High $380.19 | Professional | None | $363.08 | $363.08 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | None | $275.42 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,398.83 Typical High $4,365.16 | Facility | None | $512.86 | $2,398.83 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $724.44 | Professional | None | $478.63 | $501.19 | $724.44 |
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 $309.03 Median $363.08 Typical High $794.33 | Professional | None | $309.03 | $363.08 | $794.33 |
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 $177.83 Typical High $190.55 | Professional | 52 · Reduced service | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $72.44 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $38.02 |
Where Maryland sits
The same service costs 28.2 times more in Texas than in Kentucky. 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· 43rd of 51
$363
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.