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 $912.01 Median $912.01 Typical High $1,148.15 | Professional | None | $912.01 | $912.01 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $13,803.84 Typical High $21,877.62 | Facility | None | $11,748.98 | $13,803.84 | $21,877.62 |
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 $457.09 Median $457.09 Typical High $575.44 | Professional | 52 · Reduced service | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $114.82 |
Where Maryland sits
The same service costs 5754.4 times more in Oklahoma than in Maine. 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
$9,333
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.