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 $131.83 Median $218.78 Typical High $263.03 | Professional | None | $131.83 | $218.78 | $263.03 |
BCBS Arizona Setting Facility Modifier None Typical Low $33.88 Median $81.28 Typical High $213.80 | Facility | None | $33.88 | $81.28 | $213.80 |
BCBS Arizona Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $316.23 | Professional | None | $95.50 | $177.83 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $288.40 | Professional | None | $117.49 | $199.53 | $288.40 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $323.59 Typical High $1,584.89 | Facility | None | $134.90 | $323.59 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $912.01 Typical High $1,548.82 | Professional | None | $181.97 | $912.01 | $1,548.82 |
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 $107.15 Median $177.83 Typical High $302.00 | Professional | None | $107.15 | $177.83 | $302.00 |
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 $67.61 Median $93.33 Typical High $114.82 | Professional | 52 · Reduced service | $67.61 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $37.15 Typical High $45.71 | Professional | 53 · Discontinued | $26.92 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $100.00 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $19.95 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.62 Typical High $22.91 | Professional | 56 · Pre-op care only | $13.49 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $93.33 | $131.83 | $158.49 |
Where Arizona sits
The same service costs 4.5 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
$209
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.