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 $1,096.48 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,096.48 | $1,148.15 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,230.27 Median $2,951.21 Typical High $7,762.47 | Facility | None | $1,230.27 | $2,951.21 | $7,762.47 |
BCBS Arizona Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,862.09 | Professional | None | $954.99 | $954.99 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,318.26 | $3,388.44 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,071.52 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $13,803.84 | Facility | None | $1,047.13 | $4,466.84 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $7,244.36 | Professional | None | $977.24 | $1,412.54 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,096.48 | $6,309.57 | $9,772.37 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,905.46 | Professional | None | $977.24 | $1,148.15 | $1,905.46 |
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 $549.54 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $831.76 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $794.33 |
Where Arizona sits
The same service costs 5.1 times more in Wisconsin 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· 19th of 51
$1,905
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.