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 $208.93 Median $288.40 Typical High $323.59 | Professional | None | $208.93 | $288.40 | $323.59 |
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 $239.88 Median $446.68 Typical High $549.54 | Professional | None | $239.88 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $363.08 Typical High $2,691.53 | Facility | None | $263.03 | $363.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $398.11 | Professional | None | $204.17 | $275.42 | $398.11 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $891.25 Typical High $2,511.89 | Facility | None | $302.00 | $891.25 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,737.80 Typical High $2,630.27 | Professional | None | $275.42 | $1,737.80 | $2,630.27 |
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 $194.98 Median $257.04 Typical High $380.19 | Professional | None | $194.98 | $257.04 | $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 $104.71 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $104.71 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $41.69 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $154.88 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $30.90 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $20.89 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $144.54 | $204.17 | $229.09 |
Where Arizona sits
The same service costs 3.6 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· 37th of 51
$324
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.