How much rates vary
Facilitymedian $2,239 · 10th to 90th $631 to $6,166Professionalmedian $501 · 10th to 90th $339 to $2,754
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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $512.86 | Professional | None | $338.84 | $467.74 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $426.58 Median $676.08 Typical High $933.25 | Professional | None | $426.58 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,890.45 Typical High $7,585.78 | Facility | None | $758.58 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $691.83 | Professional | None | $338.84 | $457.09 | $691.83 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $1,621.81 Typical High $19,952.62 | Facility | None | $489.78 | $1,621.81 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $2,754.23 Typical High $4,073.80 | Professional | None | $467.74 | $2,754.23 | $4,073.80 |
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 $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
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 $169.82 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $169.82 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $89.13 Typical High $100.00 | Professional | 53 · Discontinued | $67.61 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $251.19 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $50.12 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $234.42 | $309.03 | $346.74 |
Where Arizona sits
The same service costs 6.4 times more in Alaska 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
AK $8,723MT $1,361
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.