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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $245.47 | Professional | None | $114.82 | $199.53 | $245.47 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $457.09 | Professional | None | $138.04 | $257.04 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $2,691.53 | Facility | None | $165.96 | $234.42 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $288.40 | Professional | None | $117.49 | $190.55 | $288.40 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $870.96 Typical High $2,511.89 | Facility | None | $162.18 | $870.96 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $912.01 Typical High $1,621.81 | Professional | None | $186.21 | $912.01 | $1,621.81 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $295.12 | Professional | None | $114.82 | $181.97 | $295.12 |
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 $57.54 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $57.54 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $38.90 Typical High $39.81 | Professional | 53 · Discontinued | $22.91 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $85.11 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $16.98 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.50 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.48 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $138.04 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $79.43 | $138.04 | $138.04 |
Where Arizona sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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· 23rd of 51
$240
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.