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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $123.03 | Professional | None | $81.28 | $107.15 | $123.03 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $120.23 | Professional | None | $64.57 | $83.18 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $144.54 | Professional | None | $83.18 | $107.15 | $144.54 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $316.23 Typical High $1,584.89 | Facility | None | $107.15 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $691.83 Typical High $933.25 | Professional | None | $107.15 | $691.83 | $933.25 |
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 $81.28 Median $107.15 Typical High $147.91 | Professional | None | $81.28 | $107.15 | $147.91 |
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 $40.74 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $40.74 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.22 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $79.43 Typical High $79.43 | Professional | 54 · Surgery only | $61.66 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.30 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.13 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $57.54 | $74.13 | $74.13 |
Where Arizona sits
The same service costs 3.8 times more in Alaska than in New York. 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· 42nd of 51
$115
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.