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 $213.80 Median $245.47 Typical High $245.47 | Professional | None | $213.80 | $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 $269.15 Median $331.13 Typical High $489.78 | Professional | None | $269.15 | $331.13 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $281.84 | Facility | None | $66.07 | $151.36 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $380.19 | Professional | None | $208.93 | $245.47 | $380.19 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $2,344.23 | Facility | None | $199.53 | $331.13 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,737.80 Typical High $1,995.26 | Professional | None | $223.87 | $1,737.80 | $1,995.26 |
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 $204.17 Median $234.42 Typical High $354.81 | Professional | None | $204.17 | $234.42 | $354.81 |
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 $107.15 Median $117.49 Typical High $123.03 | Professional | 52 · Reduced service | $107.15 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $47.86 Typical High $48.98 | Professional | 53 · Discontinued | $42.66 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $177.83 Typical High $181.97 | Professional | 54 · Surgery only | $162.18 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $32.36 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.99 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.38 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $165.96 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $151.36 | $165.96 | $169.82 |
Where Arizona sits
The same service costs 5.1 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· 40th 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.