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 $151.36 Median $234.42 Typical High $288.40 | Professional | None | $151.36 | $234.42 | $288.40 |
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 $181.97 Median $302.00 Typical High $575.44 | Professional | None | $181.97 | $302.00 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $1,659.59 | Facility | None | $204.17 | $288.40 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $371.54 | Professional | None | $158.49 | $239.88 | $371.54 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $870.96 Typical High $2,511.89 | Facility | None | $218.78 | $870.96 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $1,230.27 Typical High $1,905.46 | Professional | None | $234.42 | $1,230.27 | $1,905.46 |
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 $151.36 Median $234.42 Typical High $380.19 | Professional | None | $151.36 | $234.42 | $380.19 |
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 $75.86 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $114.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $107.15 | $162.18 | $162.18 |
Where Arizona sits
The same service costs 4.3 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
$302
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.