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 $154.88 Median $213.80 Typical High $239.88 | Professional | None | $154.88 | $213.80 | $239.88 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $363.08 | Professional | None | $177.83 | $281.84 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $2,691.53 | Facility | None | $154.88 | $218.78 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $288.40 | Professional | None | $147.91 | $204.17 | $288.40 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $870.96 Typical High $2,951.21 | Facility | None | $213.80 | $870.96 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $1,230.27 Typical High $1,737.80 | Professional | None | $204.17 | $1,230.27 | $1,737.80 |
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 $144.54 Median $194.98 Typical High $263.03 | Professional | None | $144.54 | $194.98 | $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 $77.62 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $77.62 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $30.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $15.49 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $151.36 |
Where Arizona sits
The same service costs 3.8 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
$219
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.