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 $245.47 Median $331.13 Typical High $354.81 | Professional | None | $245.47 | $331.13 | $354.81 |
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 $288.40 Median $436.52 Typical High $562.34 | Professional | None | $288.40 | $436.52 | $562.34 |
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 $251.19 Median $323.59 Typical High $446.68 | Professional | None | $251.19 | $323.59 | $446.68 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $933.25 Typical High $7,943.28 | Facility | None | $354.81 | $933.25 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,995.26 Typical High $2,691.53 | Professional | None | $323.59 | $1,995.26 | $2,691.53 |
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 $239.88 Median $302.00 Typical High $416.87 | Professional | None | $239.88 | $302.00 | $416.87 |
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 $123.03 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $123.03 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $48.98 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $37.15 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $173.78 | $234.42 | $234.42 |
Where Arizona sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 35th of 51
$347
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.