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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $1,230.27 Typical High $1,513.56 | Professional | None | $363.08 | $1,230.27 | $1,513.56 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $323.59 Median $1,621.81 Typical High $2,238.72 | Professional | None | $323.59 | $1,621.81 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,905.46 Typical High $3,311.31 | Facility | None | $831.76 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $1,000.00 Typical High $1,698.24 | Professional | None | $316.23 | $1,000.00 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,187.76 Typical High $7,244.36 | Facility | None | $562.34 | $2,187.76 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $5,370.32 Typical High $10,471.29 | Professional | None | $1,174.90 | $5,370.32 | $10,471.29 |
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 $302.00 Median $1,023.29 Typical High $1,862.09 | Professional | None | $302.00 | $1,023.29 | $1,862.09 |
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 $181.97 Median $223.87 Typical High $758.58 | Professional | 52 · Reduced service | $181.97 | $223.87 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $89.13 Typical High $302.00 | Professional | 53 · Discontinued | $72.44 | $89.13 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $331.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $275.42 | $331.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $67.61 Typical High $229.09 | Professional | 55 · Aftercare only | $54.95 | $67.61 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $44.67 Typical High $151.36 | Professional | 56 · Pre-op care only | $36.31 | $44.67 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $309.03 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $257.04 | $309.03 | $1,071.52 |
Where Arizona sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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· 26th of 51
$1,514
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.