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 $165.96 Median $229.09 Typical High $239.88 | Professional | None | $165.96 | $229.09 | $239.88 |
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 $194.98 Median $309.03 Typical High $389.05 | Professional | None | $194.98 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $363.08 Typical High $1,659.59 | Facility | None | $281.84 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $316.23 | Professional | None | $162.18 | $218.78 | $316.23 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $371.54 Typical High $2,041.74 | Facility | None | $181.97 | $371.54 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,348.96 Typical High $2,398.83 | Professional | None | $229.09 | $1,348.96 | $2,398.83 |
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 $154.88 Median $208.93 Typical High $281.84 | Professional | None | $154.88 | $208.93 | $281.84 |
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 $83.18 Median $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $83.18 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $169.82 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $34.67 Typical High $35.48 | Professional | 55 · Aftercare only | $25.12 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $158.49 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $158.49 | $165.96 |
Where Arizona sits
The same service costs 4.2 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· 36th of 51
$240
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.