How much rates vary
Facilitymedian $1,698 · 10th to 90th $977 to $5,888Professionalmedian $891 · 10th to 90th $257 to $2,754
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 $5,888.44 Typical High $14,125.38 | Facility | None | $977.24 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $977.24 Typical High $2,754.23 | Professional | None | $181.97 | $977.24 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $5,128.61 | Facility | None | $1,023.29 | $1,698.24 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $588.84 Typical High $1,698.24 | Professional | None | $223.87 | $588.84 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $977.24 Typical High $3,890.45 | Facility | None | $288.40 | $977.24 | $3,890.45 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $977.24 Typical High $2,754.23 | Professional | None | $457.09 | $977.24 | $2,754.23 |
Premera BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,041.74 | Facility | None | $1,288.25 | $1,513.56 | $2,041.74 |
Premera BCBS Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $2,238.72 | Professional | None | $724.44 | $724.44 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $5,128.61 | Facility | None | $1,023.29 | $1,698.24 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $190.55 Median $549.54 Typical High $1,548.82 | Professional | None | $190.55 | $549.54 | $1,548.82 |
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 $186.21 Median $537.03 Typical High $1,548.82 | Professional | None | $186.21 | $537.03 | $1,548.82 |
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 $91.20 Median $489.78 Typical High $1,380.38 | Professional | 52 · Reduced service | $91.20 | $489.78 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $199.53 Typical High $549.54 | Professional | 53 · Discontinued | $36.31 | $199.53 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $741.31 Typical High $2,041.74 | Professional | 54 · Surgery only | $138.04 | $741.31 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $147.91 Typical High $407.38 | Professional | 55 · Aftercare only | $27.54 | $147.91 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $97.72 Typical High $275.42 | Professional | 56 · Pre-op care only | $18.20 | $97.72 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $489.78 Typical High $1,380.38 | Professional | 52 · Reduced service | $114.82 | $489.78 | $1,380.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $199.53 Typical High $549.54 | Professional | 53 · Discontinued | $45.71 | $199.53 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $741.31 Typical High $2,041.74 | Professional | 54 · Surgery only | $173.78 | $741.31 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $147.91 Typical High $407.38 | Professional | 55 · Aftercare only | $34.67 | $147.91 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $97.72 Typical High $275.42 | Professional | 56 · Pre-op care only | $22.91 | $97.72 | $275.42 |
Where Alaska sits
The same service costs 4.8 times more in Colorado than in Maryland. 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 $4,327MD $911
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.