How much rates vary
Facilitymedian $3,890 · 10th to 90th $724 to $8,913Professionalmedian $562 · 10th to 90th $468 to $5,248
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 $501.19 Median $501.19 Typical High $524.81 | Professional | None | $501.19 | $501.19 | $524.81 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $4,073.80 | Facility | None | $630.96 | $1,905.46 | $4,073.80 |
BCBS Arizona Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,122.02 | Professional | None | $616.60 | $741.31 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,890.45 Typical High $7,585.78 | Facility | None | $794.33 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $831.76 | Professional | None | $457.09 | $512.86 | $831.76 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $4,466.84 Typical High $19,952.62 | Facility | None | $724.44 | $4,466.84 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $5,248.07 | Professional | None | $467.74 | $645.65 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,096.48 | $6,309.57 | $9,772.37 |
United Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $812.83 | Professional | None | $457.09 | $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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Arizona sits
The same service costs 7.9 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 $13,941MT $1,762
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.