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 $4,897.79 Median $5,370.32 Typical High $5,623.41 | Professional | None | $4,897.79 | $5,370.32 | $5,623.41 |
CareFirst Setting Professional Modifier None Typical Low $4,570.88 Median $5,128.61 Typical High $5,495.41 | Professional | None | $4,570.88 | $5,128.61 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,786.30 Median $5,370.32 Typical High $8,317.64 | Professional | None | $4,786.30 | $5,370.32 | $8,317.64 |
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 $3,630.78 Median $5,888.44 Typical High $12,302.69 | Professional | None | $3,630.78 | $5,888.44 | $12,302.69 |
Wellpoint Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $7,079.46 | Professional | None | $3,981.07 | $3,981.07 | $7,079.46 |
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 $2,570.40 Median $2,570.40 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,570.40 | $2,570.40 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,047.13 Typical High $1,122.02 | Professional | 53 · Discontinued | $1,047.13 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $3,890.45 Typical High $4,168.69 | Professional | 54 · Surgery only | $3,890.45 | $3,890.45 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | 56 · Pre-op care only | $524.81 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,630.78 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,630.78 | $3,890.45 |
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· 33rd of 51
$4,898
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.