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 $109.65 Median $208.93 Typical High $208.93 | Professional | None | $109.65 | $208.93 | $208.93 |
BCBS Arizona Setting Facility Modifier None Typical Low $173.78 Median $416.87 Typical High $1,096.48 | Facility | None | $173.78 | $416.87 | $1,096.48 |
BCBS Arizona Setting Professional Modifier None Typical Low $131.83 Median $275.42 Typical High $331.13 | Professional | None | $131.83 | $275.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $181.97 Typical High $1,659.59 | Facility | None | $128.82 | $181.97 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $263.03 | Professional | None | $112.20 | $190.55 | $263.03 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $371.54 Typical High $2,041.74 | Facility | None | $134.90 | $371.54 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $870.96 Typical High $1,698.24 | Professional | None | $199.53 | $870.96 | $1,698.24 |
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 $104.71 Median $177.83 Typical High $234.42 | Professional | None | $104.71 | $177.83 | $234.42 |
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 $54.95 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $83.18 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $16.60 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $134.90 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $77.62 | $134.90 | $147.91 |
Where Arizona sits
The same service costs 3.5 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· 27th of 51
$209
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.