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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | None | $457.09 | $457.09 | $512.86 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $812.83 | Professional | None | $416.87 | $416.87 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,090.30 Typical High $6,025.60 | Facility | None | $691.83 | $3,090.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $660.69 | Professional | None | $338.84 | $436.52 | $660.69 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $2,754.23 Typical High $13,182.57 | Facility | None | $537.03 | $2,754.23 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $3,019.95 | Professional | None | $346.74 | $524.81 | $3,019.95 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,244.36 | Facility | None | $812.83 | $2,951.21 | $7,244.36 |
United Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $707.95 | Professional | None | $331.13 | $398.11 | $707.95 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $323.59 |
Where Arizona sits
The same service costs 5.4 times more in Alaska than in New York. 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· 14th of 51
$977
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.