How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,175 to $6,607Professionalmedian $871 · 10th to 90th $251 to $1,349
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 $1,348.96 Median $9,549.93 Typical High $16,595.87 | Facility | None | $1,348.96 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $1,348.96 Typical High $1,348.96 | Professional | None | $245.47 | $1,348.96 | $1,348.96 |
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 $257.04 Median $354.81 Typical High $831.76 | Professional | None | $257.04 | $354.81 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $5,370.32 Typical High $5,370.32 | Facility | None | $1,348.96 | $5,370.32 | $5,370.32 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $870.96 Typical High $1,380.38 | Professional | None | $251.19 | $870.96 | $1,380.38 |
Premera BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,412.54 | $2,041.74 |
Premera BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $60.26 Median $363.08 Typical High $741.31 | Professional | None | $60.26 | $363.08 | $741.31 |
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 $234.42 Median $691.83 Typical High $1,621.81 | Professional | None | $234.42 | $691.83 | $1,621.81 |
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 $123.03 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $123.03 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $48.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $186.21 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $37.15 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $24.55 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $125.89 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $51.29 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $190.55 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $38.02 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $25.12 | $134.90 | $134.90 |
Where Alaska sits
The same service costs 5.6 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 $4,320MT $769
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.