How much rates vary
Facilitymedian $1,905 · 10th to 90th $468 to $5,012Professionalmedian $479 · 10th to 90th $447 to $759
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 $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $588.84 | Professional | None | $467.74 | $489.78 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | None | $467.74 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,630.78 Typical High $6,025.60 | Facility | None | $446.68 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $851.14 | Professional | None | $416.87 | $467.74 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $831.76 | Professional | None | $467.74 | $537.03 | $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 $389.05 Median $467.74 Typical High $1,023.29 | Professional | None | $389.05 | $467.74 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $724.44 | Professional | None | $467.74 | $467.74 | $724.44 |
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 $234.42 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $338.84 |
Where Maryland sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.