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 $125.89 Median $194.98 Typical High $263.03 | Professional | None | $125.89 | $194.98 | $263.03 |
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 $112.20 Median $190.55 Typical High $363.08 | Professional | None | $112.20 | $190.55 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $2,691.53 | Facility | None | $165.96 | $229.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $302.00 | Professional | None | $128.82 | $199.53 | $302.00 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $316.23 Typical High $2,344.23 | Facility | None | $138.04 | $316.23 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $1,023.29 Typical High $1,621.81 | Professional | None | $199.53 | $1,023.29 | $1,621.81 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $323.59 | Professional | None | $125.89 | $194.98 | $323.59 |
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 $63.10 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $63.10 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $37.15 Typical High $39.81 | Professional | 53 · Discontinued | $25.12 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $138.04 Typical High $147.91 | Professional | 54 · Surgery only | $95.50 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.62 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.59 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $128.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $89.13 | $128.82 | $138.04 |
Where Arizona sits
The same service costs 3.5 times more in Wisconsin 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· 35th of 51
$224
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.