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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $467.74 | Professional | None | $275.42 | $338.84 | $467.74 |
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 $234.42 Median $295.12 Typical High $398.11 | Professional | None | $234.42 | $295.12 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $2,570.40 | Facility | None | $691.83 | $1,445.44 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $457.09 | Professional | None | $269.15 | $323.59 | $457.09 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,621.81 Typical High $6,760.83 | Facility | None | $371.54 | $1,621.81 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $2,344.23 Typical High $2,884.03 | Professional | None | $331.13 | $2,344.23 | $2,884.03 |
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 $269.15 Median $331.13 Typical High $467.74 | Professional | None | $269.15 | $331.13 | $467.74 |
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 $138.04 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $27.54 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $234.42 |
Where Arizona sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 33rd of 51
$398
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.