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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $338.84 | Professional | None | $147.91 | $239.88 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $354.81 | Professional | None | $123.03 | $194.98 | $354.81 |
BCBS Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $275.42 | Professional | None | $125.89 | $186.21 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $218.78 Typical High $407.38 | Facility | None | $66.07 | $218.78 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $309.03 | Professional | None | $147.91 | $229.09 | $309.03 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $346.74 Typical High $2,344.23 | Facility | None | $162.18 | $346.74 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,258.93 Typical High $2,089.30 | Professional | None | $223.87 | $1,258.93 | $2,089.30 |
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 $147.91 Median $213.80 Typical High $302.00 | Professional | None | $147.91 | $213.80 | $302.00 |
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 $74.13 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $74.13 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $29.51 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $109.65 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $21.88 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.79 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $102.33 | $154.88 | $169.82 |
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· 37th of 51
$251
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.