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 $141.25 Median $239.88 Typical High $263.03 | Professional | None | $141.25 | $239.88 | $263.03 |
BCBS Arizona 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 Arizona Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $426.58 | Professional | None | $173.78 | $323.59 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,659.59 | Facility | None | $537.03 | $870.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $316.23 | Professional | None | $141.25 | $223.87 | $316.23 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $870.96 Typical High $3,981.07 | Facility | None | $204.17 | $870.96 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,174.90 Typical High $1,995.26 | Professional | None | $223.87 | $1,174.90 | $1,995.26 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $309.03 | Professional | None | $134.90 | $213.80 | $309.03 |
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 $70.79 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $70.79 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $28.18 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $162.18 Typical High $177.83 | Professional | 54 · Surgery only | $107.15 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $151.36 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $100.00 | $151.36 | $165.96 |
Where Arizona sits
The same service costs 4.5 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· 35th of 51
$245
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.