How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,288 to $7,079Professionalmedian $977 · 10th to 90th $282 to $1,549
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 $1,548.82 Median $9,549.93 Typical High $16,595.87 | Facility | None | $1,548.82 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $1,548.82 Typical High $1,548.82 | Professional | None | $275.42 | $1,548.82 | $1,548.82 |
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 $281.84 Median $398.11 Typical High $851.14 | Professional | None | $281.84 | $398.11 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $1,548.82 Typical High $2,187.76 | Facility | None | $446.68 | $1,548.82 | $2,187.76 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $977.24 Typical High $1,548.82 | Professional | None | $281.84 | $977.24 | $1,548.82 |
Premera BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $2,137.96 | Facility | None | $1,288.25 | $1,862.09 | $2,137.96 |
Premera BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $7,079.46 | Facility | None | $1,380.38 | $2,238.72 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $398.11 Typical High $851.14 | Professional | None | $60.26 | $398.11 | $851.14 |
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 $263.03 Median $794.33 Typical High $1,819.70 | Professional | None | $263.03 | $794.33 | $1,819.70 |
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 $138.04 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $138.04 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $54.95 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $208.93 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $41.69 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $27.54 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $141.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $56.23 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $213.80 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $42.66 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $28.18 | $154.88 | $154.88 |
Where Alaska sits
The same service costs 5.2 times more in Oklahoma 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
OK $4,508MT $873
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.