How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,023 to $5,888Professionalmedian $575 · 10th to 90th $170 to $912
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 $912.01 Median $6,606.93 Typical High $16,595.87 | Facility | None | $912.01 | $6,606.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $912.01 Typical High $912.01 | Professional | None | $165.96 | $912.01 | $912.01 |
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 $177.83 Median $251.19 Typical High $512.86 | Professional | None | $177.83 | $251.19 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $912.01 Typical High $4,073.80 | Facility | None | $269.15 | $912.01 | $4,073.80 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $588.84 Typical High $954.99 | Professional | None | $177.83 | $588.84 | $954.99 |
Premera BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,089.30 | Facility | None | $1,023.29 | $1,412.54 | $2,089.30 |
Premera BCBS Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $5,128.61 | Facility | None | $912.01 | $1,621.81 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $263.03 Typical High $512.86 | Professional | None | $60.26 | $263.03 | $512.86 |
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 $158.49 Median $467.74 Typical High $1,096.48 | Professional | None | $158.49 | $467.74 | $1,096.48 |
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 $83.18 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $83.18 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $33.11 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $125.89 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $25.12 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $16.60 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $87.10 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $34.67 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $128.82 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $25.70 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $17.38 | $91.20 | $91.20 |
Where Alaska sits
The same service costs 7.7 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 $4,047MT $526
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.