How much rates vary
Facilitymedian $1,622 · 10th to 90th $468 to $2,754Professionalmedian $200 · 10th to 90th $155 to $372
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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $309.03 | Professional | None | $151.36 | $154.88 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $251.19 | Professional | None | $177.83 | $199.53 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,737.80 Typical High $2,818.38 | Facility | None | $446.68 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $467.74 | Professional | None | $169.82 | $208.93 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $363.08 | Professional | None | $173.78 | $199.53 | $363.08 |
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 $162.18 Median $239.88 Typical High $457.09 | Professional | None | $162.18 | $239.88 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $263.03 | Professional | None | $173.78 | $173.78 | $263.03 |
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 $75.86 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $75.86 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $30.20 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 54 · Surgery only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $26.30 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $123.03 |
Where Maryland sits
The same service costs 8.1 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 $4,634MT $570
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.