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 $162.18 Median $245.47 Typical High $245.47 | Professional | None | $162.18 | $245.47 | $245.47 |
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 $190.55 Median $331.13 Typical High $436.52 | Professional | None | $190.55 | $331.13 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,659.59 | Facility | None | $512.86 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $346.74 | Professional | None | $158.49 | $229.09 | $346.74 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $616.60 Typical High $3,981.07 | Facility | None | $245.47 | $616.60 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $1,318.26 Typical High $2,041.74 | Professional | None | $234.42 | $1,318.26 | $2,041.74 |
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 $151.36 Median $218.78 Typical High $338.84 | Professional | None | $151.36 | $218.78 | $338.84 |
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 $79.43 Median $112.20 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $44.67 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $120.23 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $173.78 |
Where Arizona sits
The same service costs 4.1 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· 38th of 51
$257
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.