How much rates vary
Facilitymedian $479 · 10th to 90th $257 to $1,047Professionalmedian $158 · 10th to 90th $100 to $339
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 $102.33 Median $114.82 Typical High $338.84 | Facility | None | $102.33 | $114.82 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $239.88 Typical High $275.42 | Professional | None | $102.33 | $239.88 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $776.25 | Facility | None | $363.08 | $489.78 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $208.93 Typical High $363.08 | Professional | None | $95.50 | $208.93 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $512.86 | Professional | None | $295.12 | $331.13 | $512.86 |
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 $93.33 Median $218.78 Typical High $457.09 | Professional | None | $93.33 | $218.78 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $457.09 | Professional | None | $245.47 | $245.47 | $457.09 |
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 $51.29 Median $67.61 Typical High $138.04 | Professional | 52 · Reduced service | $51.29 | $67.61 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $56.23 | Professional | 53 · Discontinued | $20.42 | $26.92 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $100.00 Typical High $208.93 | Professional | 54 · Surgery only | $75.86 | $100.00 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $41.69 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $27.54 |
Where Maryland sits
The same service costs 5.3 times more in New York than in Maine. 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 $2,695ME $510
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.