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 $1,445.44 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,479.11 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,288.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,230.27 | $1,698.24 |
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 $851.14 Median $1,096.48 Typical High $2,398.83 | Professional | None | $851.14 | $1,096.48 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,737.80 | Professional | None | $954.99 | $954.99 | $1,737.80 |
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 $741.31 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $741.31 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,122.02 |
Where Maryland sits
The same service costs 7.8 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· 40th of 51
$1,288
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.