How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,047 to $8,318Professionalmedian $776 · 10th to 90th $661 to $6,761
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 $5,128.61 Typical High $8,317.64 | Facility | None | $977.24 | $5,128.61 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,412.54 | Professional | None | $660.69 | $660.69 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,318.26 Median $3,162.28 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,162.28 | $8,317.64 |
BCBS Arizona Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,698.24 | Professional | None | $776.25 | $831.76 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,318.26 | $3,467.37 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,318.26 | Professional | None | $660.69 | $707.95 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $16,218.10 | Facility | None | $776.25 | $4,786.30 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $6,760.83 | Professional | None | $676.08 | $1,000.00 | $6,760.83 |
United 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 |
United Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,412.54 | Professional | None | $660.69 | $758.58 | $1,412.54 |
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 $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Where Arizona sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.