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 $91.20 Median $117.49 Typical High $144.54 | Professional | None | $91.20 | $117.49 | $144.54 |
BCBS Arizona Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $616.60 | Facility | None | $97.72 | $234.42 | $616.60 |
BCBS Arizona Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $218.78 | Professional | None | $79.43 | $114.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $1,659.59 | Facility | None | $81.28 | $114.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $181.97 | Professional | None | $77.62 | $104.71 | $181.97 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $316.23 Typical High $1,584.89 | Facility | None | $107.15 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $660.69 Typical High $870.96 | Professional | None | $104.71 | $660.69 | $870.96 |
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 $79.43 Median $104.71 Typical High $177.83 | Professional | None | $79.43 | $104.71 | $177.83 |
7 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 $45.71 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $18.20 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $85.11 Typical High $89.13 | Professional | 54 · Surgery only | $67.61 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $18.20 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.48 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.12 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $79.43 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $63.10 | $79.43 | $83.18 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 58 · Staged procedure | $117.49 | $117.49 | $123.03 |
Where Arizona sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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
$120
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.