How much rates vary
Facilitymedian $7,079 · 10th to 90th $2,239 to $15,488Professionalmedian $1,023 · 10th to 90th $275 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 $10,964.78 Typical High $16,595.87 | Facility | None | $1,548.82 | $10,964.78 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $1,548.82 Typical High $1,548.82 | Professional | None | $275.42 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $8,709.64 Typical High $26,302.68 | Facility | None | $5,248.07 | $8,709.64 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $812.83 | Professional | None | $275.42 | $389.05 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,548.82 Typical High $2,238.72 | Facility | None | $467.74 | $1,548.82 | $2,238.72 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $1,202.26 Typical High $1,584.89 | Professional | None | $288.40 | $1,202.26 | $1,584.89 |
Premera BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $4,265.80 Typical High $7,079.46 | Facility | None | $3,388.44 | $4,265.80 | $7,079.46 |
Premera BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $1,584.89 Median $8,317.64 Typical High $20,417.38 | Facility | None | $1,584.89 | $8,317.64 | $20,417.38 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $426.58 Typical High $812.83 | Professional | None | $60.26 | $426.58 | $812.83 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $24,547.09 | Facility | None | $4,265.80 | $9,772.37 | $24,547.09 |
United Setting Professional Modifier None Typical Low $257.04 Median $794.33 Typical High $1,995.26 | Professional | None | $257.04 | $794.33 | $1,995.26 |
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 $138.04 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $138.04 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $54.95 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $204.17 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $40.74 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $27.54 | $154.88 | $154.88 |
Moda Health 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 |
Moda Health 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 |
Moda Health 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 |
Moda Health 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 |
Moda Health 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 |
Where Alaska sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.