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 $676.08 Median $676.08 Typical High $776.25 | Professional | None | $676.08 | $676.08 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $6,918.31 Median $8,128.31 Typical High $12,882.50 | Facility | None | $6,918.31 | $8,128.31 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
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 $338.84 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $77.62 |
Where Maryland sits
The same service costs 281.8 times more in Minnesota than in Montana. 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· 37th of 51
$7,079
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.