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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $407.38 | Professional | None | $281.84 | $389.05 | $407.38 |
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 $346.74 Median $537.03 Typical High $741.31 | Professional | None | $346.74 | $537.03 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $2,691.53 | Facility | None | $281.84 | $398.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $575.44 | Professional | None | $288.40 | $380.19 | $575.44 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,445.44 Typical High $3,630.78 | Facility | None | $407.38 | $1,445.44 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $2,344.23 Typical High $3,388.44 | Professional | None | $389.05 | $2,344.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $562.34 | Professional | None | $269.15 | $371.54 | $562.34 |
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 $141.25 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $141.25 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $56.23 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $275.42 Typical High $302.00 | Professional | 54 · Surgery only | $208.93 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $54.95 Typical High $60.26 | Professional | 55 · Aftercare only | $41.69 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $257.04 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $194.98 | $257.04 | $281.84 |
Where Arizona sits
The same service costs 4.5 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· 36th of 51
$427
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.