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 $128.82 Median $251.19 Typical High $316.23 | Professional | None | $128.82 | $251.19 | $316.23 |
BCBS Arizona Setting Facility Modifier None Typical Low $74.13 Median $177.83 Typical High $467.74 | Facility | None | $74.13 | $177.83 | $467.74 |
BCBS Arizona Setting Professional Modifier None Typical Low $173.78 Median $446.68 Typical High $575.44 | Professional | None | $173.78 | $446.68 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $229.09 | Facility | None | $66.07 | $123.03 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $363.08 | Professional | None | $117.49 | $229.09 | $363.08 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $346.74 Typical High $2,344.23 | Facility | None | $138.04 | $346.74 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,288.25 Typical High $2,570.40 | Professional | None | $229.09 | $1,288.25 | $2,570.40 |
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 $117.49 Median $218.78 Typical High $331.13 | Professional | None | $117.49 | $218.78 | $331.13 |
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 $64.57 Median $93.33 Typical High $151.36 | Professional | 52 · Reduced service | $64.57 | $93.33 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $60.26 | Professional | 53 · Discontinued | $25.70 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $141.25 Typical High $223.87 | Professional | 54 · Surgery only | $97.72 | $141.25 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $44.67 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $131.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $91.20 | $131.83 | $208.93 |
Where Arizona sits
The same service costs 3.6 times more in Wisconsin 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· 24th of 51
$269
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.