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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $275.42 | Professional | None | $144.54 | $213.80 | $275.42 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $112.20 Median $251.19 Typical High $263.03 | Professional | None | $112.20 | $251.19 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $2,187.76 | Facility | None | $489.78 | $660.69 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $309.03 | Professional | None | $120.23 | $223.87 | $309.03 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $933.25 Typical High $3,388.44 | Facility | None | $275.42 | $933.25 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,023.29 Typical High $2,884.03 | Professional | None | $229.09 | $1,023.29 | $2,884.03 |
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 $112.20 Median $213.80 Typical High $295.12 | Professional | None | $112.20 | $213.80 | $295.12 |
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 $72.44 Median $102.33 Typical High $138.04 | Professional | 52 · Reduced service | $72.44 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $28.84 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $107.15 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $41.69 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $190.55 |
Where Arizona sits
The same service costs 4.7 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· 15th of 51
$316
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.