How much rates vary
Facilitymedian $398 · 10th to 90th $257 to $1,047Professionalmedian $132 · 10th to 90th $100 to $234
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 $213.80 Median $213.80 Typical High $323.59 | Facility | None | $213.80 | $213.80 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $173.78 | Professional | None | $107.15 | $154.88 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | None | $112.20 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $407.38 Typical High $707.95 | Facility | None | $331.13 | $407.38 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $263.03 | Professional | None | $100.00 | $147.91 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $309.03 | Professional | None | $181.97 | $208.93 | $309.03 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $302.00 | Professional | None | $87.10 | $147.91 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $281.84 | Professional | None | $158.49 | $158.49 | $281.84 |
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 $53.70 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.30 Typical High $34.67 | Professional | 53 · Discontinued | $21.38 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $100.00 Typical High $131.83 | Professional | 54 · Surgery only | $81.28 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $16.22 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.18 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $13.18 | $17.38 |
Where Maryland sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.