How much rates vary
Facilitymedian $1,318 · 10th to 90th $794 to $5,888Professionalmedian $617 · 10th to 90th $191 to $1,585
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 $5,888.44 Typical High $14,125.38 | Facility | None | $831.76 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $831.76 Typical High $1,584.89 | Professional | None | $154.88 | $831.76 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $316.23 Typical High $794.33 | Professional | 53 · Discontinued | $57.54 | $316.23 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,318.26 Typical High $3,981.07 | Facility | None | $794.33 | $1,318.26 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $912.01 | Professional | None | $162.18 | $346.74 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $1,202.26 Typical High $3,162.28 | Facility | None | $245.47 | $1,202.26 | $3,162.28 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $831.76 Typical High $1,862.09 | Professional | None | $218.78 | $831.76 | $1,862.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $316.23 Typical High $794.33 | Professional | 53 · Discontinued | $74.13 | $316.23 | $794.33 |
Premera BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,584.89 | Facility | None | $776.25 | $1,148.15 | $1,584.89 |
Premera BCBS Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,288.25 | Professional | None | $616.60 | $616.60 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $1,318.26 Typical High $3,981.07 | Facility | None | $831.76 | $1,318.26 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $389.05 Typical High $912.01 | Professional | None | $151.36 | $389.05 | $912.01 |
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 $162.18 Median $426.58 Typical High $1,174.90 | Professional | None | $162.18 | $426.58 | $1,174.90 |
8 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 $79.43 Median $416.87 Typical High $794.33 | Professional | 52 · Reduced service | $79.43 | $416.87 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $630.96 Typical High $1,202.26 | Professional | 54 · Surgery only | $120.23 | $630.96 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $125.89 Typical High $239.88 | Professional | 55 · Aftercare only | $23.99 | $125.89 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $83.18 Typical High $158.49 | Professional | 56 · Pre-op care only | $15.85 | $83.18 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $416.87 Typical High $794.33 | Professional | 52 · Reduced service | $151.36 | $416.87 | $794.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $630.96 Typical High $1,202.26 | Professional | 54 · Surgery only | $147.91 | $630.96 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $125.89 Typical High $239.88 | Professional | 55 · Aftercare only | $29.51 | $125.89 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $83.18 Typical High $158.49 | Professional | 56 · Pre-op care only | $19.95 | $83.18 | $158.49 |
Where Alaska sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.