How much rates vary
Facilitymedian $1,096 · 10th to 90th $447 to $1,698Professionalmedian $148 · 10th to 90th $74 to $309
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 $87.10 Median $138.04 Typical High $331.13 | Facility | None | $87.10 | $138.04 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $269.15 | Professional | None | $69.18 | $158.49 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | None | $85.11 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,258.93 Typical High $2,041.74 | Facility | None | $512.86 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $177.83 Typical High $331.13 | Professional | None | $74.13 | $177.83 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $323.59 | Professional | None | $162.18 | $223.87 | $323.59 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $75.86 Median $173.78 Typical High $354.81 | Professional | None | $75.86 | $173.78 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $295.12 | Professional | None | $147.91 | $147.91 | $295.12 |
5 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 $34.67 Median $72.44 Typical High $93.33 | Professional | 52 · Reduced service | $34.67 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $28.84 Typical High $37.15 | Professional | 53 · Discontinued | $13.80 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $107.15 Typical High $141.25 | Professional | 54 · Surgery only | $52.48 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $21.38 Typical High $28.18 | Professional | 55 · Aftercare only | $10.47 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $14.45 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.92 | $14.45 | $18.62 |
Where Maryland sits
The same service costs 9.7 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 $4,351MT $447
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.