How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,096 to $7,079Professionalmedian $631 · 10th to 90th $182 to $977
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 $977.24 Median $9,549.93 Typical High $16,595.87 | Facility | None | $977.24 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $977.24 Typical High $977.24 | Professional | None | $177.83 | $977.24 | $977.24 |
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 $177.83 Median $257.04 Typical High $537.03 | Professional | None | $177.83 | $257.04 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $977.24 Typical High $1,412.54 | Facility | None | $281.84 | $977.24 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $741.31 Typical High $1,023.29 | Professional | None | $190.55 | $741.31 | $1,023.29 |
Premera BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,905.46 | $2,691.53 |
Premera BCBS Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $7,079.46 | Facility | None | $954.99 | $2,238.72 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $257.04 Typical High $537.03 | Professional | None | $60.26 | $257.04 | $537.03 |
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 $169.82 Median $501.19 Typical High $1,174.90 | Professional | None | $169.82 | $501.19 | $1,174.90 |
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 $89.13 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $89.13 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $35.48 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $131.83 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $26.30 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $17.78 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $91.20 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $36.31 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $134.90 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $27.54 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $18.20 | $97.72 | $97.72 |
Where Alaska sits
The same service costs 7.3 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 $4,136MT $564
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.