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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $151.36 | Professional | None | $109.65 | $141.25 | $151.36 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $263.03 | Professional | None | $91.20 | $138.04 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $218.78 | Professional | None | $95.50 | $128.82 | $218.78 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $316.23 Typical High $1,584.89 | Facility | None | $123.03 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $794.33 Typical High $1,071.52 | Professional | None | $120.23 | $794.33 | $1,071.52 |
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 $93.33 Median $123.03 Typical High $213.80 | Professional | None | $93.33 | $123.03 | $213.80 |
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 $54.95 Median $69.18 Typical High $74.13 | Professional | 52 · Reduced service | $54.95 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $27.54 Typical High $29.51 | Professional | 53 · Discontinued | $22.39 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $112.20 | Professional | 54 · Surgery only | $83.18 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $95.50 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $77.62 | $95.50 | $104.71 |
Where Arizona sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 38th of 51
$145
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.