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 $147.91 Median $218.78 Typical High $234.42 | Professional | None | $147.91 | $218.78 | $234.42 |
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 $177.83 Median $316.23 Typical High $416.87 | Professional | None | $177.83 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $257.04 Typical High $1,659.59 | Facility | None | $186.21 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $331.13 | Professional | None | $144.54 | $218.78 | $331.13 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $851.14 Typical High $2,511.89 | Facility | None | $213.80 | $851.14 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $1,230.27 Typical High $1,905.46 | Professional | None | $218.78 | $1,230.27 | $1,905.46 |
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 $141.25 Median $208.93 Typical High $309.03 | Professional | None | $141.25 | $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 $74.13 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $74.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $29.51 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $112.20 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $22.39 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.79 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $104.71 | $147.91 | $162.18 |
Where Arizona sits
The same service costs 3.7 times more in Alaska than in Utah. 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.