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 $331.13 Median $398.11 Typical High $524.81 | Professional | None | $331.13 | $398.11 | $524.81 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $457.09 | Professional | None | $281.84 | $407.38 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $2,691.53 | Facility | None | $295.12 | $416.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $537.03 | Professional | None | $269.15 | $346.74 | $537.03 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $1,513.56 Typical High $3,630.78 | Facility | None | $416.87 | $1,513.56 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $2,570.40 Typical High $3,235.94 | Professional | None | $316.23 | $2,570.40 | $3,235.94 |
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 $263.03 Median $338.84 Typical High $524.81 | Professional | None | $263.03 | $338.84 | $524.81 |
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 $177.83 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $316.23 |
Where Arizona sits
The same service costs 5.0 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· 31st of 51
$457
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.