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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $295.12 | Professional | None | $169.82 | $295.12 | $295.12 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $512.86 | Professional | None | $208.93 | $389.05 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,897.79 Typical High $9,549.93 | Facility | None | $758.58 | $4,897.79 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $426.58 | Professional | None | $169.82 | $302.00 | $426.58 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $19,952.62 | Facility | None | $323.59 | $1,445.44 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,162.28 | Professional | None | $316.23 | $1,380.38 | $3,162.28 |
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 $162.18 Median $295.12 Typical High $416.87 | Professional | None | $162.18 | $295.12 | $416.87 |
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 $85.11 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $33.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $117.49 | $208.93 | $208.93 |
Where Arizona sits
The same service costs 5.1 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· 26th of 51
$339
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.