How much rates vary
Facilitymedian $3,236 · 10th to 90th $977 to $7,762Professionalmedian $1,445 · 10th to 90th $1,230 to $9,550
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 $1,380.38 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,445.44 | $1,659.59 |
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 $1,230.27 Median $1,230.27 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,230.27 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,548.82 | $3,388.44 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,348.96 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,398.83 Typical High $7,244.36 | Facility | None | $758.58 | $2,398.83 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $9,549.93 | Professional | None | $1,202.26 | $1,737.80 | $9,549.93 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,244.36 | Facility | None | $812.83 | $2,951.21 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,380.38 | $2,344.23 |
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 $724.44 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,023.29 |
Where Arizona sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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
AL $18,462KY $2,797
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.