How much rates vary
Facilitymedian $1,148 · 10th to 90th $550 to $4,467Professionalmedian $275 · 10th to 90th $229 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 $3,090.30 Typical High $6,760.83 | Facility | None | $977.24 | $3,090.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $354.81 | Professional | None | $229.09 | $229.09 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | None | $194.98 | $194.98 | $213.80 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | None | $275.42 | $275.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $3,311.31 | Facility | None | $616.60 | $794.33 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $389.05 | Professional | None | $245.47 | $257.04 | $389.05 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $3,630.78 | Facility | None | $346.74 | $954.99 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $1,862.09 | Professional | None | $239.88 | $323.59 | $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 $229.09 Median $263.03 Typical High $363.08 | Professional | None | $229.09 | $263.03 | $363.08 |
5 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 $128.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $25.70 |
Where Arizona sits
The same service costs 5.6 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 $4,320MT $769
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.