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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | None | $138.04 | $208.93 | $208.93 |
BCBS Arizona Setting Facility Modifier None Typical Low $380.19 Median $891.25 Typical High $2,344.23 | Facility | None | $380.19 | $891.25 | $2,344.23 |
BCBS Arizona Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $234.42 | Professional | None | $97.72 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $588.84 Typical High $1,659.59 | Facility | None | $436.52 | $588.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $331.13 | Professional | None | $131.83 | $223.87 | $331.13 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $2,818.38 | Facility | None | $223.87 | $616.60 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,174.90 Typical High $1,778.28 | Professional | None | $223.87 | $1,174.90 | $1,778.28 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $316.23 | Professional | None | $131.83 | $213.80 | $316.23 |
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 $69.18 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $69.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $27.54 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $20.42 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.80 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $95.50 | $144.54 | $144.54 |
Where Arizona sits
The same service costs 4.2 times more in Alaska than in Virginia. 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
$234
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.