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 $467.74 Median $512.86 Typical High $707.95 | Professional | None | $467.74 | $512.86 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $588.84 Typical High $2,691.53 | Facility | None | $489.78 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $1,318.26 | Professional | None | $501.19 | $549.54 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $912.01 | Professional | None | $537.03 | $616.60 | $912.01 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
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 $234.42 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $234.42 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $354.81 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $51.29 |
Where Maryland sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 40th of 51
$513
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.