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 $851.14 Median $851.14 Typical High $912.01 | Professional | None | $851.14 | $851.14 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,548.82 | Professional | None | $851.14 | $977.24 | $1,548.82 |
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 $630.96 Median $794.33 Typical High $1,737.80 | Professional | None | $630.96 | $794.33 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,318.26 | Professional | None | $758.58 | $758.58 | $1,318.26 |
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 $426.58 Median $426.58 Typical High $457.09 | Professional | 52 · Reduced service | $426.58 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | 53 · Discontinued | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $630.96 |
Where Maryland sits
The same service costs 8.9 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
$912
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.