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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $478.63 | Professional | None | $338.84 | $467.74 | $478.63 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $831.76 | Professional | None | $416.87 | $616.60 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $891.25 Typical High $3,311.31 | Facility | None | $676.08 | $891.25 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $676.08 | Professional | None | $346.74 | $457.09 | $676.08 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,981.07 | Facility | None | $363.08 | $691.83 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $2,754.23 Typical High $3,890.45 | Professional | None | $457.09 | $2,754.23 | $3,890.45 |
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 $331.13 Median $446.68 Typical High $660.69 | Professional | None | $331.13 | $446.68 | $660.69 |
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 $165.96 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $165.96 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $67.61 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $331.13 Typical High $354.81 | Professional | 54 · Surgery only | $251.19 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $50.12 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $309.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $234.42 | $309.03 | $331.13 |
Where Arizona sits
The same service costs 4.8 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· 39th of 51
$490
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.