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 $263.03 Median $346.74 Typical High $446.68 | Professional | None | $263.03 | $346.74 | $446.68 |
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 $316.23 Median $457.09 Typical High $870.96 | Professional | None | $316.23 | $457.09 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,698.24 Typical High $3,019.95 | Facility | None | $691.83 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $602.56 | Professional | None | $269.15 | $363.08 | $602.56 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,621.81 Typical High $7,943.28 | Facility | None | $380.19 | $1,621.81 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $2,137.96 Typical High $2,754.23 | Professional | None | $338.84 | $2,137.96 | $2,754.23 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $602.56 | Professional | None | $275.42 | $354.81 | $602.56 |
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 $131.83 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $131.83 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $39.81 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $239.88 |
Where Arizona sits
The same service costs 4.9 times more in Alaska 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· 26th of 51
$490
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.