How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,175 to $9,550Professionalmedian $661 · 10th to 90th $191 to $1,023
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 $1,023.29 Median $9,549.93 Typical High $16,595.87 | Facility | None | $1,023.29 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $1,023.29 Typical High $1,023.29 | Professional | None | $186.21 | $1,023.29 | $1,023.29 |
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 $190.55 Median $269.15 Typical High $562.34 | Professional | None | $190.55 | $269.15 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $1,023.29 Typical High $10,471.29 | Facility | None | $302.00 | $1,023.29 | $10,471.29 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $776.25 Typical High $1,071.52 | Professional | None | $194.98 | $776.25 | $1,071.52 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,238.72 Typical High $7,079.46 | Facility | None | $1,023.29 | $2,238.72 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $269.15 Typical High $562.34 | Professional | None | $60.26 | $269.15 | $562.34 |
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 $177.83 Median $524.81 Typical High $1,230.27 | Professional | None | $177.83 | $524.81 | $1,230.27 |
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 $93.33 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $93.33 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $37.15 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $141.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $28.18 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $18.62 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $95.50 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $38.90 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $144.54 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $28.84 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $19.50 | $102.33 | $102.33 |
Where Alaska sits
The same service costs 7.0 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 $4,147MT $590
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.