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 $218.78 Typical High $229.09 | Professional | None | $141.25 | $218.78 | $229.09 |
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 $169.82 Median $316.23 Typical High $416.87 | Professional | None | $169.82 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $263.03 Typical High $1,659.59 | Facility | None | $186.21 | $263.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $316.23 | Professional | None | $138.04 | $213.80 | $316.23 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $602.56 Typical High $1,995.26 | Facility | None | $204.17 | $602.56 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,905.46 | Professional | None | $218.78 | $1,148.15 | $1,905.46 |
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 $134.90 Median $208.93 Typical High $309.03 | Professional | None | $134.90 | $208.93 | $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 $114.82 | Professional | 52 · Reduced service | $70.79 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $45.71 | Professional | 53 · Discontinued | $28.18 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $173.78 | Professional | 54 · Surgery only | $104.71 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $32.36 Typical High $34.67 | Professional | 55 · Aftercare only | $21.38 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $162.18 |
Where Arizona sits
The same service costs 4.4 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
$240
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.