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 $97.72 Median $107.15 Typical High $112.20 | Professional | None | $97.72 | $107.15 | $112.20 |
BCBS Arizona Setting Facility Modifier None Typical Low $85.11 Median $199.53 Typical High $524.81 | Facility | None | $85.11 | $199.53 | $524.81 |
BCBS Arizona Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $223.87 | Professional | None | $123.03 | $147.91 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $173.78 | Facility | None | $66.07 | $93.33 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $173.78 | Professional | None | $89.13 | $109.65 | $173.78 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $331.13 Typical High $1,584.89 | Facility | None | $112.20 | $331.13 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $776.25 Typical High $891.25 | Professional | None | $100.00 | $776.25 | $891.25 |
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 $89.13 Median $102.33 Typical High $154.88 | Professional | None | $89.13 | $102.33 | $154.88 |
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 $48.98 Median $53.70 Typical High $56.23 | Professional | 52 · Reduced service | $48.98 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.38 Typical High $22.39 | Professional | 53 · Discontinued | $19.50 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $79.43 Typical High $83.18 | Professional | 54 · Surgery only | $74.13 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.85 Typical High $16.60 | Professional | 55 · Aftercare only | $14.79 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.77 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $74.13 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $69.18 | $74.13 | $77.62 |
Where Arizona sits
The same service costs 4.5 times more in Alaska than in Florida. 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
$115
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.