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 $5,370.32 Median $5,888.44 Typical High $6,025.60 | Professional | None | $5,370.32 | $5,888.44 | $6,025.60 |
CareFirst Setting Professional Modifier None Typical Low $4,570.88 Median $5,128.61 Typical High $5,128.61 | Professional | None | $4,570.88 | $5,128.61 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,677.35 Median $5,248.07 Typical High $9,772.37 | Professional | None | $4,677.35 | $5,248.07 | $9,772.37 |
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 $3,890.45 Median $5,754.40 Typical High $13,182.57 | Professional | None | $3,890.45 | $5,754.40 | $13,182.57 |
Wellpoint Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $7,079.46 | Professional | None | $3,890.45 | $3,890.45 | $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 $2,754.23 Median $2,951.21 Typical High $3,019.95 | Professional | 52 · Reduced service | $2,754.23 | $2,951.21 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $1,096.48 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $4,466.84 Typical High $4,466.84 | Professional | 54 · Surgery only | $4,073.80 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 55 · Aftercare only | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $588.84 Typical High $602.56 | Professional | 56 · Pre-op care only | $549.54 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,801.89 Median $4,168.69 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $3,801.89 | $4,168.69 | $4,168.69 |
Where Maryland sits
The same service costs 9.1 times more in Alaska than in Arkansas. 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· 42nd of 51
$4,571
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.