How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,175 to $7,244Professionalmedian $661 · 10th to 90th $195 to $1,072
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 $1,071.52 Median $9,549.93 Typical High $16,595.87 | Facility | None | $1,071.52 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $1,071.52 Typical High $1,621.81 | Professional | None | $194.98 | $1,071.52 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $7,079.46 | Facility | None | $1,380.38 | $2,290.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $660.69 | Professional | None | $204.17 | $309.03 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $1,071.52 Typical High $7,244.36 | Facility | None | $316.23 | $1,071.52 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $691.83 Typical High $1,122.02 | Professional | None | $199.53 | $691.83 | $1,122.02 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Providence Setting Facility Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $7,079.46 | Facility | None | $1,071.52 | $2,238.72 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $389.05 Typical High $588.84 | Professional | None | $151.36 | $389.05 | $588.84 |
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 $186.21 Median $549.54 Typical High $1,513.56 | Professional | None | $186.21 | $549.54 | $1,513.56 |
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 $97.72 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $97.72 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $38.90 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $144.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $28.84 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $19.50 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $97.72 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $38.90 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $147.91 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $29.51 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $19.50 | $107.15 | $107.15 |
Where Alaska sits
The same service costs 6.8 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 $4,179MT $618
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.