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 $186.21 Median $295.12 Typical High $407.38 | Professional | None | $186.21 | $295.12 | $407.38 |
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 $158.49 Median $245.47 Typical High $380.19 | Professional | None | $158.49 | $245.47 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $489.78 Typical High $2,187.76 | Facility | None | $389.05 | $489.78 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $407.38 | Professional | None | $186.21 | $275.42 | $407.38 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $2,041.74 | Facility | None | $199.53 | $398.11 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,584.89 Typical High $2,818.38 | Professional | None | $295.12 | $1,584.89 | $2,818.38 |
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 $181.97 Median $263.03 Typical High $407.38 | Professional | None | $181.97 | $263.03 | $407.38 |
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 $93.33 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $93.33 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $58.88 Typical High $66.07 | Professional | 53 · Discontinued | $37.15 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $245.47 | Professional | 54 · Surgery only | $141.25 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $28.18 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $131.83 | $208.93 | $229.09 |
Where Arizona sits
The same service costs 3.4 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· 31st of 51
$347
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.