How much rates vary
Facilitymedian $1,380 · 10th to 90th $437 to $4,898Professionalmedian $224 · 10th to 90th $174 to $1,862
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 $3,715.35 Typical High $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | None | $229.09 | $229.09 | $275.42 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $354.81 | Professional | None | $158.49 | $169.82 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $3,019.95 | Facility | None | $512.86 | $1,659.59 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $354.81 | Professional | None | $181.97 | $208.93 | $354.81 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $954.99 Typical High $7,943.28 | Facility | None | $380.19 | $954.99 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $1,862.09 | Professional | None | $181.97 | $275.42 | $1,862.09 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $380.19 | Professional | None | $177.83 | $208.93 | $380.19 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $158.49 |
Where Arizona sits
The same service costs 7.2 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 $4,681MT $647
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.