How much rates vary
Facilitymedian $4,169 · 10th to 90th $832 to $9,550Professionalmedian $562 · 10th to 90th $457 to $4,266
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 $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | None | $446.68 | $446.68 | $501.19 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $2,041.74 Typical High $4,897.79 | Facility | None | $776.25 | $2,041.74 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,174.90 | Professional | None | $645.65 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,011.87 Typical High $9,772.37 | Facility | None | $851.14 | $5,011.87 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $831.76 | Professional | None | $478.63 | $537.03 | $831.76 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $4,466.84 Typical High $25,703.96 | Facility | None | $707.95 | $4,466.84 | $25,703.96 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $4,265.80 | Professional | None | $457.09 | $645.65 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,606.93 Typical High $9,772.37 | Facility | None | $1,096.48 | $6,606.93 | $9,772.37 |
United Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $812.83 | Professional | None | $446.68 | $512.86 | $812.83 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $363.08 |
Where Arizona sits
The same service costs 7.5 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 $13,659MT $1,825
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.