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 $4,265.80 Median $4,265.80 Typical High $4,897.79 | Professional | None | $4,265.80 | $4,265.80 | $4,897.79 |
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 $3,801.89 Median $4,466.84 Typical High $12,882.50 | Professional | None | $3,801.89 | $4,466.84 | $12,882.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,265.80 Median $4,897.79 Typical High $7,413.10 | Professional | None | $4,265.80 | $4,897.79 | $7,413.10 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $5,370.32 Typical High $10,232.93 | Professional | None | $3,548.13 | $5,370.32 | $10,232.93 |
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 $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 53 · Discontinued | $851.14 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,235.94 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,235.94 | $3,235.94 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $645.65 Typical High $741.31 | Professional | 55 · Aftercare only | $645.65 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $489.78 |
Where Maryland sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 45th of 51
$3,548
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.