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 $239.88 Median $323.59 Typical High $380.19 | Professional | None | $239.88 | $323.59 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $371.54 | Professional | None | $186.21 | $371.54 | $371.54 |
BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $645.65 | Professional | None | $302.00 | $478.63 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $323.59 Typical High $575.44 | Facility | None | $66.07 | $323.59 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $478.63 | Professional | None | $245.47 | $316.23 | $478.63 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $602.56 Typical High $2,570.40 | Facility | None | $295.12 | $602.56 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,949.84 Typical High $2,754.23 | Professional | None | $302.00 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $457.09 | Professional | None | $229.09 | $302.00 | $457.09 |
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 $120.23 Median $138.04 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $67.61 | Professional | 53 · Discontinued | $47.86 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $181.97 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $194.98 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $169.82 | $194.98 | $239.88 |
Where Arizona sits
The same service costs 4.5 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· 37th of 51
$339
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.