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 $954.99 | Professional | None | $912.01 | $912.01 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | None | $912.01 | $1,023.29 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,621.81 | Professional | None | $912.01 | $1,023.29 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,949.84 | Professional | None | $691.83 | $870.96 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,380.38 | Professional | None | $851.14 | $851.14 | $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 $457.09 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $676.08 |
Where Maryland sits
The same service costs 17.4 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
$955
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.