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 $131.83 Median $204.17 Typical High $204.17 | Professional | None | $131.83 | $204.17 | $204.17 |
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 $154.88 Median $275.42 Typical High $346.74 | Professional | None | $154.88 | $275.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $1,659.59 | Facility | None | $165.96 | $234.42 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $281.84 | Professional | None | $134.90 | $204.17 | $281.84 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $870.96 Typical High $2,570.40 | Facility | None | $186.21 | $870.96 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $1,047.13 Typical High $1,698.24 | Professional | None | $208.93 | $1,047.13 | $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 $131.83 Median $199.53 Typical High $263.03 | Professional | None | $131.83 | $199.53 | $263.03 |
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 $64.57 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $26.30 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $97.72 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $19.50 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $91.20 | $144.54 | $144.54 |
Where Arizona sits
The same service costs 3.5 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
$224
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.