How much rates vary
Facilitymedian $1,000 · 10th to 90th $427 to $4,266Professionalmedian $550 · 10th to 90th $479 to $3,890
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 Facility Modifier None Typical Low $870.96 Median $4,265.80 Typical High $7,762.47 | Facility | None | $870.96 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $812.83 | Professional | None | $478.63 | $501.19 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | None | $549.54 | $549.54 | $602.56 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,174.90 | Professional | None | $660.69 | $758.58 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,023.29 Typical High $2,691.53 | Facility | None | $724.44 | $1,023.29 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $812.83 | Professional | None | $457.09 | $524.81 | $812.83 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $4,786.30 | Facility | None | $380.19 | $707.95 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $3,890.45 Typical High $4,073.80 | Professional | None | $501.19 | $3,890.45 | $4,073.80 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $794.33 | Professional | None | $457.09 | $512.86 | $794.33 |
6 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 $239.88 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $354.81 |
Where Arizona sits
The same service costs 4.0 times more in Colorado than in Florida. 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 $4,440FL $1,118
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.