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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $165.96 | Professional | None | $114.82 | $141.25 | $165.96 |
BCBS Arizona Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $2,454.71 | Facility | None | $398.11 | $954.99 | $2,454.71 |
BCBS Arizona Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $245.47 | Professional | None | $81.28 | $128.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $1,659.59 | Facility | None | $114.82 | $162.18 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $218.78 | Professional | None | $97.72 | $138.04 | $218.78 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $851.14 Typical High $2,511.89 | Facility | None | $134.90 | $851.14 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $776.25 Typical High $1,122.02 | Professional | None | $131.83 | $776.25 | $1,122.02 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $223.87 | Professional | None | $89.13 | $134.90 | $223.87 |
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 $57.54 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $57.54 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $22.91 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $87.10 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.48 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $100.00 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $81.28 | $100.00 | $117.49 |
Where Arizona sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 29th of 51
$166
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.