How much rates vary
Facilitymedian $676 · 10th to 90th $407 to $4,677Professionalmedian $363 · 10th to 90th $91 to $1,380
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 $398.11 Median $5,888.44 Typical High $14,125.38 | Facility | None | $398.11 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $398.11 Typical High $1,380.38 | Professional | None | $75.86 | $398.11 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $2,089.30 | Facility | None | $407.38 | $676.08 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $229.09 Typical High $616.60 | Professional | None | $72.44 | $229.09 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $457.09 Typical High $1,949.84 | Facility | None | $120.23 | $457.09 | $1,949.84 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $398.11 Typical High $1,445.44 | Professional | None | $102.33 | $398.11 | $1,445.44 |
Premera BCBS Setting Facility Modifier None Typical Low $426.58 Median $616.60 Typical High $812.83 | Facility | None | $426.58 | $616.60 | $812.83 |
Premera BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,122.02 | Professional | None | $302.00 | $302.00 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $2,089.30 | Facility | None | $407.38 | $676.08 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $229.09 Typical High $776.25 | Professional | None | $72.44 | $229.09 | $776.25 |
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 $77.62 Median $251.19 Typical High $676.08 | Professional | None | $77.62 | $251.19 | $676.08 |
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 $38.02 Median $199.53 Typical High $676.08 | Professional | 52 · Reduced service | $38.02 | $199.53 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $79.43 Typical High $275.42 | Professional | 53 · Discontinued | $15.49 | $79.43 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $302.00 Typical High $1,023.29 | Professional | 54 · Surgery only | $57.54 | $302.00 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $60.26 Typical High $204.17 | Professional | 55 · Aftercare only | $11.48 | $60.26 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $39.81 Typical High $138.04 | Professional | 56 · Pre-op care only | $7.59 | $39.81 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $199.53 Typical High $676.08 | Professional | 52 · Reduced service | $47.86 | $199.53 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $79.43 Typical High $275.42 | Professional | 53 · Discontinued | $19.05 | $79.43 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $302.00 Typical High $1,023.29 | Professional | 54 · Surgery only | $72.44 | $302.00 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $60.26 Typical High $204.17 | Professional | 55 · Aftercare only | $14.45 | $60.26 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $39.81 Typical High $138.04 | Professional | 56 · Pre-op care only | $9.55 | $39.81 | $138.04 |
Where Alaska sits
The same service costs 9.0 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 $4,579MT $507
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.