How much rates vary
Facilitymedian $1,148 · 10th to 90th $631 to $2,570Professionalmedian $355 · 10th to 90th $302 to $646
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 $371.54 Median $426.58 Typical High $676.08 | Facility | None | $371.54 | $426.58 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $501.19 | Professional | None | $323.59 | $363.08 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $398.11 | Professional | None | $316.23 | $354.81 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,905.46 | Facility | None | $630.96 | $1,047.13 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $977.24 | Professional | None | $316.23 | $380.19 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $562.34 | Professional | None | $316.23 | $363.08 | $562.34 |
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 $288.40 Median $426.58 Typical High $851.14 | Professional | None | $288.40 | $426.58 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $478.63 | Professional | None | $257.04 | $257.04 | $478.63 |
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 $165.96 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $281.84 | Professional | 54 · Surgery only | $251.19 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $263.03 |
Where Maryland sits
The same service costs 5.1 times more in Oklahoma 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
OK $5,094MT $991
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.