How much rates vary
Facilitymedian $1,778 · 10th to 90th $550 to $5,370Professionalmedian $302 · 10th to 90th $155 to $1,349
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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $371.54 | Professional | None | $186.21 | $263.03 | $371.54 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $144.54 Median $309.03 Typical High $323.59 | Professional | None | $144.54 | $309.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,258.93 Typical High $2,238.72 | Facility | None | $691.83 | $1,258.93 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $389.05 | Professional | None | $158.49 | $263.03 | $389.05 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $1,445.44 Typical High $5,754.40 | Facility | None | $338.84 | $1,445.44 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,348.96 Typical High $2,454.71 | Professional | None | $263.03 | $1,348.96 | $2,454.71 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $363.08 | Professional | None | $147.91 | $251.19 | $363.08 |
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 $95.50 Median $125.89 Typical High $169.82 | Professional | 52 · Reduced service | $95.50 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $67.61 | Professional | 53 · Discontinued | $38.02 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $190.55 Typical High $251.19 | Professional | 54 · Surgery only | $141.25 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $38.02 Typical High $51.29 | Professional | 55 · Aftercare only | $28.18 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.12 Typical High $33.88 | Professional | 56 · Pre-op care only | $19.05 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $177.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $131.83 | $177.83 | $234.42 |
Where Arizona sits
The same service costs 6.3 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 $4,654MT $736
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.