How much rates vary
Facilitymedian $1,259 · 10th to 90th $550 to $4,786Professionalmedian $309 · 10th to 90th $263 to $3,388
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 $977.24 Median $3,715.35 Typical High $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $602.56 | Professional | None | $380.19 | $380.19 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,000.00 Typical High $2,187.76 | Facility | None | $691.83 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $478.63 | Professional | None | $263.03 | $309.03 | $478.63 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $954.99 Typical High $4,786.30 | Facility | None | $416.87 | $954.99 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $3,388.44 | Professional | None | $257.04 | $363.08 | $3,388.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $467.74 | Professional | None | $251.19 | $288.40 | $467.74 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $208.93 |
Where Arizona sits
The same service costs 4.6 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 $4,822MT $1,050
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.