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 $537.03 Median $588.84 Typical High $691.83 | Professional | None | $537.03 | $588.84 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,818.38 | Facility | None | $512.86 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $1,071.52 | Professional | None | $173.78 | $190.55 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $354.81 | Professional | None | $239.88 | $275.42 | $354.81 |
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 $562.34 Median $891.25 Typical High $1,621.81 | Professional | None | $562.34 | $891.25 | $1,621.81 |
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 $269.15 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $69.18 |
Where Maryland sits
The same service costs 53.7 times more in Alaska 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· 26th of 51
$912
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.