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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $954.99 | Professional | None | $478.63 | $478.63 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,691.53 Typical High $4,786.30 | Facility | None | $851.14 | $2,691.53 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $776.25 | Professional | None | $436.52 | $501.19 | $776.25 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $2,754.23 Typical High $12,882.50 | Facility | None | $575.44 | $2,754.23 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $7,413.10 | Professional | None | $436.52 | $602.56 | $7,413.10 |
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 $426.58 Median $501.19 Typical High $912.01 | Professional | None | $426.58 | $501.19 | $912.01 |
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 $263.03 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $380.19 |
Where Arizona sits
The same service costs 5.4 times more in Alaska 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· 11th of 51
$1,230
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.