How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,549 to $14,791Professionalmedian $1,148 · 10th to 90th $288 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 $281.84 Median $1,548.82 Typical High $1,548.82 | Professional | None | $281.84 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $6,918.31 Median $11,481.54 Typical High $35,481.34 | Facility | None | $6,918.31 | $11,481.54 | $35,481.34 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $851.14 | Professional | None | $295.12 | $416.87 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $5,370.32 Typical High $5,370.32 | Facility | None | $1,548.82 | $5,370.32 | $5,370.32 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $1,174.90 Typical High $1,584.89 | Professional | None | $295.12 | $1,174.90 | $1,584.89 |
Premera BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $8,912.51 Typical High $10,232.93 | Facility | None | $1,412.54 | $8,912.51 | $10,232.93 |
Premera BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $1,513.56 Median $10,964.78 Typical High $25,703.96 | Facility | None | $1,513.56 | $10,964.78 | $25,703.96 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $416.87 Typical High $851.14 | Professional | None | $60.26 | $416.87 | $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 $269.15 Median $794.33 Typical High $1,862.09 | Professional | None | $269.15 | $794.33 | $1,862.09 |
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 $141.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $141.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $56.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $213.80 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $42.66 | $234.42 | $234.42 |
Aetna 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 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $144.54 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $58.88 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $218.78 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $43.65 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $29.51 | $154.88 | $154.88 |
Where Alaska sits
The same service costs 7.8 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 $7,005MT $893
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.