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 $213.80 Typical High $245.47 | Professional | None | $147.91 | $213.80 | $245.47 |
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 $117.49 Median $162.18 Typical High $234.42 | Professional | None | $117.49 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $1,659.59 | Facility | None | $147.91 | $204.17 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $281.84 | Professional | None | $147.91 | $204.17 | $281.84 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $2,344.23 | Facility | None | $162.18 | $323.59 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $1,258.93 Typical High $1,819.70 | Professional | None | $208.93 | $1,258.93 | $1,819.70 |
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 $151.36 Median $199.53 Typical High $281.84 | Professional | None | $151.36 | $199.53 | $281.84 |
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 $72.44 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $72.44 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $21.88 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $102.33 | $147.91 | $147.91 |
Where Arizona sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$229
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.