How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,096 to $7,079Professionalmedian $537 · 10th to 90th $151 to $832
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 $831.76 Median $9,549.93 Typical High $16,595.87 | Facility | None | $831.76 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $831.76 Typical High $831.76 | Professional | None | $147.91 | $831.76 | $831.76 |
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 $154.88 Median $218.78 Typical High $457.09 | Professional | None | $154.88 | $218.78 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $831.76 Typical High $1,202.26 | Facility | None | $239.88 | $831.76 | $1,202.26 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $616.60 Typical High $851.14 | Professional | None | $154.88 | $616.60 | $851.14 |
Premera BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,630.78 Typical High $5,128.61 | Facility | None | $1,513.56 | $3,630.78 | $5,128.61 |
Premera BCBS Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $812.83 | $2,238.72 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $218.78 Typical High $457.09 | Professional | None | $60.26 | $218.78 | $457.09 |
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 $141.25 Median $426.58 Typical High $1,000.00 | Professional | None | $141.25 | $426.58 | $1,000.00 |
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 $75.86 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $75.86 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $30.20 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $112.20 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $22.39 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $15.14 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $77.62 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $30.90 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $117.49 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $23.44 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $15.49 | $83.18 | $83.18 |
Where Alaska sits
The same service costs 11.1 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 $5,221MT $469
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.