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 $3,548.13 Median $3,548.13 Typical High $3,801.89 | Professional | None | $3,548.13 | $3,548.13 | $3,801.89 |
CareFirst Setting Professional Modifier None Typical Low $3,090.30 Median $3,467.37 Typical High $3,715.35 | Professional | None | $3,090.30 | $3,467.37 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $5,623.41 | Professional | None | $3,235.94 | $3,630.78 | $5,623.41 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $2,630.27 Median $4,073.80 Typical High $8,317.64 | Professional | None | $2,630.27 | $4,073.80 | $8,317.64 |
Wellpoint Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $4,786.30 | Professional | None | $2,691.53 | $2,691.53 | $4,786.30 |
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 $1,778.28 Median $1,778.28 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | 53 · Discontinued | $707.95 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $380.19 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,630.27 |
Where Maryland sits
The same service costs 22.9 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· 37th of 51
$3,311
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.