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 $891.25 Median $891.25 Typical High $933.25 | Professional | None | $891.25 | $891.25 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | None | $870.96 | $977.24 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,621.81 | Professional | None | $891.25 | $1,000.00 | $1,621.81 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,819.70 | Professional | None | $660.69 | $831.76 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,380.38 | Professional | None | $794.33 | $794.33 | $1,380.38 |
6 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 $436.52 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $660.69 |
Where Maryland sits
The same service costs 16.2 times more in Alaska than in Texas. 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· 39th of 51
$933
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.