How much rates vary
Facilitymedian $1,349 · 10th to 90th $427 to $4,571Professionalmedian $372 · 10th to 90th $170 to $1,660
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 $169.82 Median $371.54 Typical High $489.78 | Professional | None | $169.82 | $371.54 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $426.58 Typical High $446.68 | Professional | None | $169.82 | $426.58 | $446.68 |
BCBS Arizona Setting Facility Modifier None Typical Low $354.81 Median $831.76 Typical High $2,187.76 | Facility | None | $354.81 | $831.76 | $2,187.76 |
BCBS Arizona Setting Professional Modifier None Typical Low $125.89 Median $331.13 Typical High $416.87 | Professional | None | $125.89 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,949.84 | Facility | None | $851.14 | $1,148.15 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $380.19 Typical High $562.34 | Professional | None | $190.55 | $380.19 | $562.34 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $1,412.54 Typical High $5,128.61 | Facility | None | $416.87 | $1,412.54 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $1,659.59 Typical High $3,235.94 | Professional | None | $398.11 | $1,659.59 | $3,235.94 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $5,623.41 | Facility | None | $831.76 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $549.54 | Professional | None | $208.93 | $371.54 | $549.54 |
7 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 $85.11 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $85.11 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $33.88 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $125.89 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $25.12 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.98 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $117.49 | $229.09 | $263.03 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 50 · Both sides | $257.04 | $257.04 | $257.04 |
Where Arizona sits
The same service costs 4.6 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 $4,728MT $1,029
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.