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 $407.38 Median $407.38 Typical High $446.68 | Professional | None | $407.38 | $407.38 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,585.78 Typical High $12,589.25 | Facility | None | $512.86 | $7,585.78 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $954.99 | Professional | None | $407.38 | $467.74 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $691.83 | Professional | None | $467.74 | $537.03 | $691.83 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $954.99 | Professional | None | $346.74 | $524.81 | $954.99 |
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 $204.17 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $81.28 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $309.03 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $44.67 |
Where Maryland sits
The same service costs 5.9 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· 31st of 51
$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.