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 $186.21 Median $275.42 Typical High $302.00 | Professional | None | $186.21 | $275.42 | $302.00 |
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 $223.87 Median $363.08 Typical High $691.83 | Professional | None | $223.87 | $363.08 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $416.87 Typical High $2,187.76 | Facility | None | $281.84 | $416.87 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $446.68 | Professional | None | $194.98 | $275.42 | $446.68 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $2,041.74 | Facility | None | $199.53 | $389.05 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,698.24 Typical High $2,187.76 | Professional | None | $275.42 | $1,698.24 | $2,187.76 |
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 $194.98 Median $281.84 Typical High $446.68 | Professional | None | $194.98 | $281.84 | $446.68 |
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 $93.33 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $141.25 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.62 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $131.83 | $190.55 | $190.55 |
Where Arizona sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 35th of 51
$324
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.