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 $1,318.26 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,348.96 | $1,445.44 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,174.90 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,148.15 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $2,818.38 Typical High $6,606.93 | Facility | None | $1,348.96 | $2,818.38 | $6,606.93 |
United Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $2,137.96 | Professional | None | $776.25 | $977.24 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,584.89 | Professional | None | $870.96 | $870.96 | $1,584.89 |
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 $676.08 Median $676.08 Typical High $724.44 | Professional | 52 · Reduced service | $676.08 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $288.40 | Professional | 53 · Discontinued | $275.42 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,023.29 |
Where Maryland sits
The same service costs 9.1 times more in Wyoming 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· 40th of 51
$1,175
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.