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 $100.00 Median $138.04 Typical High $173.78 | Professional | None | $100.00 | $138.04 | $173.78 |
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 $117.49 Median $190.55 Typical High $363.08 | Professional | None | $117.49 | $190.55 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $2,691.53 | Facility | None | $91.20 | $128.82 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $234.42 | Professional | None | $100.00 | $144.54 | $234.42 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $1,380.38 Typical High $3,890.45 | Facility | None | $144.54 | $1,380.38 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $831.76 Typical High $1,258.93 | Professional | None | $128.82 | $831.76 | $1,258.93 |
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 $107.15 Median $131.83 Typical High $239.88 | Professional | None | $107.15 | $131.83 | $239.88 |
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 $48.98 Median $67.61 Typical High $72.44 | Professional | 52 · Reduced service | $48.98 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $26.92 Typical High $28.84 | Professional | 53 · Discontinued | $19.95 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $74.13 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.42 Typical High $21.88 | Professional | 55 · Aftercare only | $14.79 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.00 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $93.33 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $69.18 | $93.33 | $100.00 |
Where Arizona sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 24th of 51
$186
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.