How much rates vary
Facilitymedian $4,169 · 10th to 90th $661 to $10,000Professionalmedian $5,129 · 10th to 90th $437 to $21,380
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 $6,606.93 Typical High $11,481.54 | Facility | None | $977.24 | $6,606.93 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $1,584.89 Typical High $5,128.61 | Professional | None | $416.87 | $1,584.89 | $5,128.61 |
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 $478.63 Median $602.56 Typical High $831.76 | Professional | None | $478.63 | $602.56 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $8,128.31 Typical High $15,848.93 | Facility | None | $1,548.82 | $8,128.31 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,148.15 Typical High $7,943.28 | Professional | None | $457.09 | $1,148.15 | $7,943.28 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $5,011.87 Typical High $9,332.54 | Facility | None | $707.95 | $5,011.87 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $6,606.93 Median $21,379.62 Typical High $42,657.95 | Professional | None | $6,606.93 | $21,379.62 | $42,657.95 |
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 $436.52 Median $5,248.07 Typical High $8,709.64 | Professional | None | $436.52 | $5,248.07 | $8,709.64 |
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 $204.17 Median $2,511.89 Typical High $2,570.40 | Professional | 52 · Reduced service | $204.17 | $2,511.89 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $83.18 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $3,801.89 Typical High $3,890.45 | Professional | 54 · Surgery only | $309.03 | $3,801.89 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $758.58 Typical High $776.25 | Professional | 55 · Aftercare only | $61.66 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $41.69 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $3,548.13 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $288.40 | $3,548.13 | $3,630.78 |
Where Arizona sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.