How much rates vary
Facilitymedian $2,138 · 10th to 90th $977 to $5,888Professionalmedian $562 · 10th to 90th $162 to $1,905
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $691.83 Median $5,888.44 Typical High $14,125.38 | Facility | None | $691.83 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $691.83 Typical High $1,905.46 | Professional | None | $134.90 | $691.83 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $5,248.07 | Facility | None | $1,380.38 | $2,290.87 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $363.08 Typical High $1,096.48 | Professional | None | $134.90 | $363.08 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $691.83 Typical High $2,691.53 | Facility | None | $204.17 | $691.83 | $2,691.53 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $691.83 Typical High $1,905.46 | Professional | None | $181.97 | $691.83 | $1,905.46 |
Premera BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,454.71 | Facility | None | $1,258.93 | $1,862.09 | $2,454.71 |
Premera BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,548.82 | Professional | None | $524.81 | $524.81 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $2,238.72 Typical High $5,248.07 | Facility | None | $977.24 | $2,238.72 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $380.19 Typical High $1,071.52 | Professional | None | $125.89 | $380.19 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $134.90 Median $354.81 Typical High $1,148.15 | Professional | None | $134.90 | $354.81 | $1,148.15 |
10 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 $66.07 Median $346.74 Typical High $954.99 | Professional | 52 · Reduced service | $66.07 | $346.74 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $138.04 Typical High $380.19 | Professional | 53 · Discontinued | $26.92 | $138.04 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $524.81 Typical High $1,412.54 | Professional | 54 · Surgery only | $100.00 | $524.81 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $104.71 Typical High $288.40 | Professional | 55 · Aftercare only | $19.95 | $104.71 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $69.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $13.49 | $69.18 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $346.74 Typical High $954.99 | Professional | 52 · Reduced service | $83.18 | $346.74 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $138.04 Typical High $380.19 | Professional | 53 · Discontinued | $33.11 | $138.04 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $524.81 Typical High $1,412.54 | Professional | 54 · Surgery only | $123.03 | $524.81 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $104.71 Typical High $288.40 | Professional | 55 · Aftercare only | $24.55 | $104.71 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $69.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $16.60 | $69.18 | $190.55 |
Where Alaska sits
The same service costs 5.7 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 $4,090MT $722
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.