How much rates vary
Facilitymedian $2,630 · 10th to 90th $776 to $6,918Professionalmedian $603 · 10th to 90th $501 to $4,365
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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,047.13 | Professional | None | $676.08 | $676.08 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $3,630.78 | Facility | None | $851.14 | $1,995.26 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $831.76 | Professional | None | $501.19 | $616.60 | $831.76 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $2,754.23 Typical High $9,549.93 | Facility | None | $630.96 | $2,754.23 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $4,365.16 | Professional | None | $501.19 | $870.96 | $4,365.16 |
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 $478.63 Median $562.34 Typical High $776.25 | Professional | None | $478.63 | $562.34 | $776.25 |
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 $275.42 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $275.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $109.65 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $407.38 |
Where Arizona sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.