How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,096 to $7,079Professionalmedian $676 · 10th to 90th $209 to $2,239
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 $912.01 Median $7,079.46 Typical High $14,125.38 | Facility | None | $912.01 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $912.01 Typical High $2,238.72 | Professional | None | $169.82 | $912.01 | $2,238.72 |
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 $173.78 Median $436.52 Typical High $1,288.25 | Professional | None | $173.78 | $436.52 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $3,235.94 | Facility | None | $524.81 | $1,288.25 | $3,235.94 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $912.01 Typical High $2,238.72 | Professional | None | $234.42 | $912.01 | $2,238.72 |
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 $676.08 Median $676.08 Typical High $1,819.70 | Professional | None | $676.08 | $676.08 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $7,079.46 | Facility | None | $1,288.25 | $2,290.87 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $478.63 Typical High $1,258.93 | Professional | None | $165.96 | $478.63 | $1,258.93 |
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 $173.78 Median $467.74 Typical High $1,445.44 | Professional | None | $173.78 | $467.74 | $1,445.44 |
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 $87.10 Median $457.09 Typical High $1,122.02 | Professional | 52 · Reduced service | $87.10 | $457.09 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $181.97 Typical High $446.68 | Professional | 53 · Discontinued | $34.67 | $181.97 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $676.08 Typical High $1,698.24 | Professional | 54 · Surgery only | $128.82 | $676.08 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $138.04 Typical High $338.84 | Professional | 55 · Aftercare only | $25.70 | $138.04 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $91.20 Typical High $223.87 | Professional | 56 · Pre-op care only | $17.38 | $91.20 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $457.09 Typical High $1,122.02 | Professional | 52 · Reduced service | $107.15 | $457.09 | $1,122.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $181.97 Typical High $446.68 | Professional | 53 · Discontinued | $42.66 | $181.97 | $446.68 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $676.08 Typical High $1,698.24 | Professional | 54 · Surgery only | $162.18 | $676.08 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $138.04 Typical High $338.84 | Professional | 55 · Aftercare only | $32.36 | $138.04 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $91.20 Typical High $223.87 | Professional | 56 · Pre-op care only | $21.38 | $91.20 | $223.87 |
Where Alaska sits
The same service costs 5.4 times more in Colorado than in West Virginia. 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 $4,173WV $767
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.