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 $5,495.41 Typical High $8,317.64 | Facility | None | $977.24 | $5,495.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $436.52 | Professional | None | $288.40 | $331.13 | $436.52 |
BCBS Setting Facility Modifier None Typical Low $891.25 Median $2,089.30 Typical High $5,495.41 | Facility | None | $891.25 | $2,089.30 | $5,495.41 |
BCBS Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $891.25 | Professional | None | $354.81 | $457.09 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,995.26 Typical High $3,801.89 | Facility | None | $977.24 | $1,995.26 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $676.08 | Professional | None | $331.13 | $380.19 | $676.08 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $1,621.81 Typical High $9,549.93 | Facility | None | $416.87 | $1,621.81 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $2,691.53 Typical High $3,090.30 | Professional | None | $363.08 | $2,691.53 | $3,090.30 |
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 $331.13 Median $389.05 Typical High $741.31 | Professional | None | $331.13 | $389.05 | $741.31 |
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 $144.54 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.84 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $234.42 | $234.42 |
Where Arizona sits
The same service costs 3.8 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· 28th of 51
$525
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.