How much rates vary
Facilitymedian $5,495 · 10th to 90th $2,570 to $14,125Professionalmedian $1,230 · 10th to 90th $331 to $1,862
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 $1,862.09 Median $10,964.78 Typical High $16,595.87 | Facility | None | $1,862.09 | $10,964.78 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,862.09 Typical High $1,862.09 | Professional | None | $323.59 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $10,964.78 Typical High $33,884.42 | Facility | None | $6,606.93 | $10,964.78 | $33,884.42 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $977.24 | Professional | None | $331.13 | $457.09 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $2,691.53 | Facility | None | $549.54 | $1,862.09 | $2,691.53 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $1,445.44 Typical High $1,905.46 | Professional | None | $338.84 | $1,445.44 | $1,905.46 |
Premera BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $4,168.69 Typical High $5,495.41 | Facility | None | $3,388.44 | $4,168.69 | $5,495.41 |
Premera BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $1,862.09 Median $10,471.29 Typical High $20,417.38 | Facility | None | $1,862.09 | $10,471.29 | $20,417.38 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $467.74 Typical High $977.24 | Professional | None | $60.26 | $467.74 | $977.24 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $7,079.46 Typical High $10,471.29 | Facility | None | $2,570.40 | $7,079.46 | $10,471.29 |
United Setting Professional Modifier None Typical Low $302.00 Median $954.99 Typical High $2,187.76 | Professional | None | $302.00 | $954.99 | $2,187.76 |
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 $162.18 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $162.18 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $64.57 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $245.47 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $48.98 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $32.36 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $169.82 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $67.61 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $251.19 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $50.12 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $33.88 | $186.21 | $186.21 |
Where Alaska sits
The same service costs 7.2 times more in Wisconsin 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
WI $7,422MT $1,038
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.