How much rates vary
Facilitymedian $1,230 · 10th to 90th $417 to $4,786Professionalmedian $191 · 10th to 90th $120 to $1,122
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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $234.42 | Professional | None | $134.90 | $194.98 | $234.42 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $363.08 | Professional | None | $117.49 | $190.55 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $2,344.23 | Facility | None | $512.86 | $1,318.26 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $295.12 | Professional | None | $117.49 | $173.78 | $295.12 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $851.14 Typical High $5,623.41 | Facility | None | $204.17 | $851.14 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $1,122.02 Typical High $1,659.59 | Professional | None | $177.83 | $1,122.02 | $1,659.59 |
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 $120.23 Median $177.83 Typical High $295.12 | Professional | None | $120.23 | $177.83 | $295.12 |
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 $67.61 Median $93.33 Typical High $100.00 | Professional | 52 · Reduced service | $67.61 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $37.15 Typical High $39.81 | Professional | 53 · Discontinued | $26.92 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $141.25 Typical High $151.36 | Professional | 54 · Surgery only | $102.33 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.18 Typical High $30.20 | Professional | 55 · Aftercare only | $20.42 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.62 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.49 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $131.83 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $95.50 | $131.83 | $141.25 |
Where Arizona sits
The same service costs 9.9 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 $4,605MT $466
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.