How much rates vary
Facilitymedian $646 · 10th to 90th $178 to $2,239Professionalmedian $288 · 10th to 90th $117 to $2,138
Distribution of negotiated rates across all payers (price axis is log-scale). 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 Professional Modifier None Typical Low $114.82 Median $645.65 Typical High $3,801.89 | Professional | None | $114.82 | $645.65 | $3,801.89 |
BCBS Montana Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | None | $165.96 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $1,202.26 Typical High $3,388.44 | Facility | None | $181.97 | $1,202.26 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $436.52 Typical High $1,949.84 | Professional | None | $173.78 | $436.52 | $1,949.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $177.83 Median $229.09 Typical High $2,238.72 | Facility | None | $177.83 | $229.09 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $2,187.76 | Professional | None | $117.49 | $218.78 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $1,202.26 Typical High $3,388.44 | Facility | None | $181.97 | $1,202.26 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $186.21 Typical High $2,137.96 | Professional | None | $79.43 | $186.21 | $2,137.96 |
United Setting Facility Modifier None Typical Low $398.11 Median $616.60 Typical High $954.99 | Facility | None | $398.11 | $616.60 | $954.99 |
United Setting Professional Modifier None Typical Low $190.55 Median $1,096.48 Typical High $2,137.96 | Professional | None | $190.55 | $1,096.48 | $2,137.96 |
5 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 $58.88 Median $323.59 Typical High $1,905.46 | Professional | 52 · Reduced service | $58.88 | $323.59 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $131.83 Typical High $758.58 | Professional | 53 · Discontinued | $23.44 | $131.83 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $489.78 Typical High $2,884.03 | Professional | 54 · Surgery only | $87.10 | $489.78 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $97.72 Typical High $575.44 | Professional | 55 · Aftercare only | $17.78 | $97.72 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $64.57 Typical High $380.19 | Professional | 56 · Pre-op care only | $11.75 | $64.57 | $380.19 |
Where Montana sits
The same service costs 5.5 times more in Hawaii than in Maryland. 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
HI $4,440MD $808
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.