How much rates vary
Facilitymedian $2,512 · 10th to 90th $776 to $6,310Professionalmedian $550 · 10th to 90th $372 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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $630.96 | Professional | None | $371.54 | $549.54 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,023.29 | Professional | None | $467.74 | $758.58 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,890.45 Typical High $7,585.78 | Facility | None | $851.14 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $776.25 | Professional | None | $380.19 | $512.86 | $776.25 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,621.81 Typical High $19,952.62 | Facility | None | $549.54 | $1,621.81 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $3,090.30 Typical High $4,570.88 | Professional | None | $524.81 | $3,090.30 | $4,570.88 |
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 $501.19 Typical High $741.31 | Professional | None | $354.81 | $501.19 | $741.31 |
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 $186.21 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $281.84 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $263.03 | $346.74 | $380.19 |
Where Arizona sits
The same service costs 6.5 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 $9,949MT $1,532
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.