How much rates vary
Facilitymedian $1,288 · 10th to 90th $457 to $2,399Professionalmedian $324 · 10th to 90th $275 to $617
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 Facility Modifier None Typical Low $288.40 Median $302.00 Typical High $501.19 | Facility | None | $288.40 | $302.00 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $489.78 | Professional | None | $288.40 | $407.38 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | None | $275.42 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $2,187.76 | Facility | None | $446.68 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $588.84 | Professional | None | $275.42 | $380.19 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $831.76 | Professional | None | $398.11 | $501.19 | $831.76 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $776.25 | Professional | None | $251.19 | $363.08 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $691.83 | Professional | None | $323.59 | $323.59 | $691.83 |
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 $144.54 Median $144.54 Typical High $208.93 | Professional | 52 · Reduced service | $144.54 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $58.88 Typical High $83.18 | Professional | 53 · Discontinued | $57.54 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $316.23 | Professional | 54 · Surgery only | $218.78 | $218.78 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $63.10 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $29.51 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.84 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $295.12 |
Where Maryland sits
The same service costs 6.1 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $6,346MT $1,043
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.