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 $4,073.80 Median $4,073.80 Typical High $4,168.69 | Professional | None | $4,073.80 | $4,073.80 | $4,168.69 |
CareFirst Setting Professional Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,890.45 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $3,630.78 Typical High $5,370.32 | Professional | None | $3,311.31 | $3,630.78 | $5,370.32 |
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 $2,754.23 Median $3,388.44 Typical High $6,760.83 | Professional | None | $2,754.23 | $3,388.44 | $6,760.83 |
Wellpoint Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,691.53 | $2,691.53 | $4,466.84 |
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 $2,041.74 Median $2,041.74 Typical High $2,089.30 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 53 · Discontinued | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,090.30 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $2,884.03 |
Where Maryland sits
The same service costs 27.5 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· 31st of 51
$3,890
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.