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 $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | None | $1,000.00 | $1,000.00 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | None | $954.99 | $1,071.52 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,621.81 | Professional | None | $891.25 | $1,023.29 | $1,621.81 |
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 $831.76 Median $1,230.27 Typical High $2,344.23 | Professional | None | $831.76 | $1,230.27 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,348.96 | Professional | None | $758.58 | $758.58 | $1,348.96 |
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 $501.19 Median $501.19 Typical High $512.86 | Professional | 52 · Reduced service | $501.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 53 · Discontinued | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $724.44 |
Where Maryland sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 38th of 51
$1,023
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.