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 $114.82 Median $154.88 Typical High $199.53 | Professional | None | $114.82 | $154.88 | $199.53 |
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 $91.20 Median $162.18 Typical High $181.97 | Professional | None | $91.20 | $162.18 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $2,570.40 | Facility | None | $512.86 | $1,445.44 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $204.17 | Professional | None | $95.50 | $141.25 | $204.17 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $851.14 Typical High $6,918.31 | Facility | None | $177.83 | $851.14 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $831.76 Typical High $1,318.26 | Professional | None | $138.04 | $831.76 | $1,318.26 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $208.93 | Professional | None | $87.10 | $131.83 | $208.93 |
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 $57.54 Median $74.13 Typical High $91.20 | Professional | 52 · Reduced service | $57.54 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $29.51 Typical High $36.31 | Professional | 53 · Discontinued | $23.44 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $87.10 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $17.38 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $81.28 | $102.33 | $128.82 |
Where Arizona sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 21st of 51
$200
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.