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 $213.80 Median $275.42 Typical High $302.00 | Professional | None | $213.80 | $275.42 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
BCBS 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 Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $478.63 | Professional | None | $239.88 | $363.08 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $2,187.76 | Facility | None | $575.44 | $794.33 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $380.19 | Professional | None | $208.93 | $269.15 | $380.19 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $933.25 Typical High $3,715.35 | Facility | None | $309.03 | $933.25 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $1,698.24 Typical High $2,290.87 | Professional | None | $269.15 | $1,698.24 | $2,290.87 |
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 $199.53 Median $257.04 Typical High $346.74 | Professional | None | $199.53 | $257.04 | $346.74 |
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 $138.04 Typical High $141.25 | Professional | 52 · Reduced service | $104.71 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $54.95 Typical High $56.23 | Professional | 53 · Discontinued | $42.66 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $158.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $31.62 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $27.54 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.38 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $147.91 | $194.98 | $194.98 |
Where Arizona sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$288
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.