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 $331.13 Median $478.63 Typical High $501.19 | Professional | None | $331.13 | $478.63 | $501.19 |
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 $380.19 Median $645.65 Typical High $794.33 | Professional | None | $380.19 | $645.65 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $3,019.95 | Facility | None | $512.86 | $1,659.59 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $616.60 | Professional | None | $323.59 | $426.58 | $616.60 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $933.25 Typical High $7,943.28 | Facility | None | $436.52 | $933.25 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $3,019.95 Typical High $4,073.80 | Professional | None | $436.52 | $3,019.95 | $4,073.80 |
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 $309.03 Median $407.38 Typical High $562.34 | Professional | None | $309.03 | $407.38 | $562.34 |
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 $165.96 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $251.19 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $50.12 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $234.42 | $316.23 | $346.74 |
Where Arizona sits
The same service costs 3.7 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· 36th of 51
$501
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.