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 $234.42 Median $309.03 Typical High $331.13 | Professional | None | $234.42 | $309.03 | $331.13 |
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 $190.55 Median $239.88 Typical High $346.74 | Professional | None | $190.55 | $239.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $213.80 Typical High $398.11 | Facility | None | $66.07 | $213.80 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $416.87 | Professional | None | $239.88 | $302.00 | $416.87 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $2,344.23 | Facility | None | $199.53 | $354.81 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $1,995.26 Typical High $2,630.27 | Professional | None | $309.03 | $1,995.26 | $2,630.27 |
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 $239.88 Median $302.00 Typical High $426.58 | Professional | None | $239.88 | $302.00 | $426.58 |
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 $117.49 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $117.49 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $46.77 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $35.48 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.44 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $165.96 | $218.78 | $218.78 |
Where Arizona sits
The same service costs 4.0 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· 41st of 51
$324
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.