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 $616.60 Median $616.60 Typical High $660.69 | Professional | None | $616.60 | $616.60 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | None | $630.96 | $691.83 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,122.02 | Professional | None | $630.96 | $707.95 | $1,122.02 |
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 $467.74 Median $588.84 Typical High $1,318.26 | Professional | None | $467.74 | $588.84 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $954.99 | Professional | None | $588.84 | $588.84 | $954.99 |
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 $309.03 Median $309.03 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $457.09 |
Where Maryland sits
The same service costs 14.1 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
$661
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.