How much rates vary
Facilitymedian $3,981 · 10th to 90th $977 to $9,120Professionalmedian $1,072 · 10th to 90th $912 to $4,571
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 $977.24 Median $977.24 Typical High $1,548.82 | Professional | None | $977.24 | $977.24 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $954.99 Typical High $977.24 | Professional | None | $114.82 | $954.99 | $977.24 |
BCBS Arizona Setting Facility Modifier None Typical Low $891.25 Median $2,238.72 Typical High $5,495.41 | Facility | None | $891.25 | $2,238.72 | $5,495.41 |
BCBS Arizona Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,412.54 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $3,890.45 Typical High $7,585.78 | Facility | None | $1,096.48 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,584.89 | Professional | None | $891.25 | $1,023.29 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,466.84 Typical High $19,952.62 | Facility | None | $1,023.29 | $4,466.84 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $7,943.28 | Professional | None | $933.25 | $1,202.26 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $5,128.61 Typical High $9,772.37 | Facility | None | $1,096.48 | $5,128.61 | $9,772.37 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,584.89 | Professional | None | $912.01 | $1,023.29 | $1,584.89 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Arizona sits
The same service costs 4.2 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 $14,362MT $3,396
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.