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 $281.84 Median $309.03 Typical High $691.83 | Professional | None | $281.84 | $309.03 | $691.83 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $309.03 | Professional | None | $218.78 | $275.42 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $251.19 Typical High $1,659.59 | Facility | None | $181.97 | $251.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $645.65 | Professional | None | $263.03 | $288.40 | $645.65 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $707.95 Typical High $4,265.80 | Facility | None | $316.23 | $707.95 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $3,235.94 Typical High $4,466.84 | Professional | None | $416.87 | $3,235.94 | $4,466.84 |
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 $275.42 Median $537.03 Typical High $676.08 | Professional | None | $275.42 | $537.03 | $676.08 |
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 $141.25 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $57.54 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $213.80 | $245.47 |
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· 18th of 51
$550
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.