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 $346.74 Median $346.74 Typical High $380.19 | Professional | None | $346.74 | $346.74 | $380.19 |
BCBS Arizona 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 Arizona Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $691.83 | Professional | None | $436.52 | $436.52 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,659.59 Typical High $2,951.21 | Facility | None | $691.83 | $1,659.59 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $537.03 | Professional | None | $302.00 | $389.05 | $537.03 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $7,943.28 | Facility | None | $501.19 | $1,905.46 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $549.54 Typical High $3,981.07 | Professional | None | $302.00 | $549.54 | $3,981.07 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $489.78 | Professional | None | $281.84 | $354.81 | $489.78 |
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 $173.78 Median $173.78 Typical High $186.21 | Professional | 52 · Reduced service | $173.78 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $263.03 |
Where Arizona sits
The same service costs 5.1 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· 41st of 51
$389
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.