How much rates vary
Facilitymedian $1,950 · 10th to 90th $120 to $7,762Professionalmedian $5,248 · 10th to 90th $3,388 to $154,882
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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $5,248.07 Typical High $5,248.07 | Professional | None | $4,786.30 | $5,248.07 | $5,248.07 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $8,317.64 | Professional | None | $3,715.35 | $3,981.07 | $8,317.64 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $6,456.54 | Facility | None | $104.71 | $1,096.48 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $6,165.95 Typical High $154,881.66 | Professional | None | $3,388.44 | $6,165.95 | $154,881.66 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $4,786.30 Typical High $9,120.11 | Professional | None | $3,235.94 | $4,786.30 | $9,120.11 |
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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,890.45 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,630.78 | $3,630.78 |
Where Arizona sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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
WI $28,671TX $3,407
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.