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 $120.23 Median $190.55 Typical High $223.87 | Professional | None | $120.23 | $190.55 | $223.87 |
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 $141.25 Median $269.15 Typical High $323.59 | Professional | None | $141.25 | $269.15 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $1,659.59 | Facility | None | $169.82 | $239.88 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $263.03 | Professional | None | $120.23 | $177.83 | $263.03 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $831.76 Typical High $2,951.21 | Facility | None | $190.55 | $831.76 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $977.24 Typical High $1,698.24 | Professional | None | $190.55 | $977.24 | $1,698.24 |
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 $169.82 Typical High $234.42 | Professional | None | $114.82 | $169.82 | $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 $60.26 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $60.26 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $23.99 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $144.54 Typical High $154.88 | Professional | 54 · Surgery only | $91.20 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $18.20 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.02 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $134.90 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $85.11 | $134.90 | $144.54 |
Where Arizona sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 33rd 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.