How much rates vary
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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $93.33 Typical High $128.82 | Professional | None | $44.67 | $93.33 | $128.82 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $109.65 | Professional | None | $35.48 | $70.79 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $85.11 Typical High $114.82 | Professional | None | $46.77 | $85.11 | $114.82 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $316.23 Typical High $1,584.89 | Facility | None | $85.11 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $436.52 Typical High $870.96 | Professional | None | $87.10 | $436.52 | $870.96 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $120.23 | Professional | None | $50.12 | $87.10 | $120.23 |
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 $22.39 Median $43.65 Typical High $50.12 | Professional | 52 · Reduced service | $22.39 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $17.38 Typical High $19.95 | Professional | 53 · Discontinued | $9.12 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $64.57 Typical High $75.86 | Professional | 54 · Surgery only | $33.88 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.88 Typical High $15.14 | Professional | 55 · Aftercare only | $6.76 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $8.71 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.47 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $60.26 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $31.62 | $60.26 | $70.79 |
Where Arizona sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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.
Arizona· 38th of 51
$100
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.