How much rates vary
Facilitymedian $1,230 · 10th to 90th $316 to $4,571Professionalmedian $380 · 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 $380.19 Typical High $489.78 | Professional | None | $169.82 | $380.19 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $426.58 Typical High $457.09 | Professional | None | $169.82 | $426.58 | $457.09 |
BCBS Arizona Setting Facility Modifier None Typical Low $245.47 Median $588.84 Typical High $1,513.56 | Facility | None | $245.47 | $588.84 | $1,513.56 |
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 $3,801.89 | Facility | None | $851.14 | $1,148.15 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $562.34 | Professional | None | $190.55 | $371.54 | $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 $389.05 Median $1,659.59 Typical High $3,311.31 | Professional | None | $389.05 | $1,659.59 | $3,311.31 |
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 $204.17 Median $363.08 Typical High $537.03 | Professional | None | $204.17 | $363.08 | $537.03 |
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 $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $85.11 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $33.88 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $125.89 | $239.88 | $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 $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $16.98 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $117.49 | $223.87 | $263.03 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $616.60 Typical High $676.08 | Professional | 50 · Both sides | $257.04 | $616.60 | $676.08 |
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 $4,720MT $1,020
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.