How much rates vary
Facilitymedian $2,042 · 10th to 90th $537 to $3,715Professionalmedian $457 · 10th to 90th $174 to $1,413
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 $199.53 Median $436.52 Typical High $1,949.84 | Facility | None | $199.53 | $436.52 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $616.60 Typical High $1,230.27 | Professional | None | $218.78 | $616.60 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | None | $173.78 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,089.30 Typical High $3,715.35 | Facility | None | $446.68 | $2,089.30 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $537.03 Typical High $1,412.54 | Professional | None | $181.97 | $537.03 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,584.89 | Professional | None | $707.95 | $933.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $186.21 Median $645.65 Typical High $1,737.80 | Professional | None | $186.21 | $645.65 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,288.25 | Professional | None | $616.60 | $616.60 | $1,288.25 |
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 $109.65 Median $295.12 Typical High $524.81 | Professional | 52 · Reduced service | $109.65 | $295.12 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $117.49 Typical High $208.93 | Professional | 53 · Discontinued | $44.67 | $117.49 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $446.68 Typical High $794.33 | Professional | 54 · Surgery only | $165.96 | $446.68 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $89.13 Typical High $158.49 | Professional | 55 · Aftercare only | $33.11 | $89.13 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $58.88 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.39 | $58.88 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $416.87 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $154.88 | $416.87 | $741.31 |
Where Maryland sits
The same service costs 5.1 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 $7,315MT $1,443
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.