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 $123.03 Median $173.78 Typical High $204.17 | Professional | None | $123.03 | $173.78 | $204.17 |
BCBS 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 Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $281.84 | Professional | None | $85.11 | $158.49 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $269.15 | Facility | None | $66.07 | $144.54 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $245.47 | Professional | None | $104.71 | $162.18 | $245.47 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $338.84 Typical High $1,584.89 | Facility | None | $134.90 | $338.84 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $831.76 Typical High $1,380.38 | Professional | None | $162.18 | $831.76 | $1,380.38 |
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 $93.33 Median $158.49 Typical High $263.03 | Professional | None | $93.33 | $158.49 | $263.03 |
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 $61.66 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $61.66 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $33.88 Typical High $40.74 | Professional | 53 · Discontinued | $24.55 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $125.89 Typical High $151.36 | Professional | 54 · Surgery only | $93.33 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $18.62 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.98 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.30 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $117.49 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $87.10 | $117.49 | $141.25 |
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· 24th of 51
$200
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.