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 $245.47 Median $338.84 Typical High $467.74 | Professional | None | $245.47 | $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 $199.53 Median $269.15 Typical High $389.05 | Professional | None | $199.53 | $269.15 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $2,187.76 | Facility | None | $630.96 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $446.68 | Professional | None | $239.88 | $323.59 | $446.68 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $933.25 Typical High $3,981.07 | Facility | None | $354.81 | $933.25 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $2,089.30 Typical High $2,884.03 | Professional | None | $338.84 | $2,089.30 | $2,884.03 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $457.09 | Professional | None | $245.47 | $323.59 | $457.09 |
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 $123.03 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $123.03 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $48.98 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $181.97 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $24.55 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $169.82 | $234.42 | $234.42 |
Where Arizona sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 32nd 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.