How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $5,370Professionalmedian $525 · 10th to 90th $380 to $3,090
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 $380.19 Median $524.81 Typical High $524.81 | Professional | None | $380.19 | $524.81 | $524.81 |
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 $467.74 Median $724.44 Typical High $1,000.00 | Professional | None | $467.74 | $724.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $2,570.40 | Facility | None | $691.83 | $1,445.44 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $758.58 | Professional | None | $371.54 | $501.19 | $758.58 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,621.81 Typical High $6,760.83 | Facility | None | $524.81 | $1,621.81 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $3,090.30 Typical High $4,365.16 | Professional | None | $501.19 | $3,090.30 | $4,365.16 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $724.44 | Professional | None | $354.81 | $478.63 | $724.44 |
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 $190.55 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $190.55 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $75.86 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $281.84 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $56.23 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $38.02 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $371.54 |
Where Arizona sits
The same service costs 4.4 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 $6,491MT $1,489
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.