How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,096 to $8,913Professionalmedian $933 · 10th to 90th $794 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 $5,623.41 Typical High $10,232.93 | Facility | None | $977.24 | $5,623.41 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,659.59 | Professional | None | $794.33 | $794.33 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $2,089.30 | Professional | None | $933.25 | $1,000.00 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,905.46 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,584.89 | Professional | None | $794.33 | $831.76 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $3,715.35 Typical High $16,218.10 | Facility | None | $870.96 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $6,760.83 | Professional | None | $812.83 | $1,230.27 | $6,760.83 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $8,317.64 | Facility | None | $977.24 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,737.80 | Professional | None | $794.33 | $933.25 | $1,737.80 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Where Arizona sits
The same service costs 4.2 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 $11,551MT $2,762
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.