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 $120.23 Median $190.55 Typical High $229.09 | Professional | None | $120.23 | $190.55 | $229.09 |
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 $107.15 Median $186.21 Typical High $346.74 | Professional | None | $107.15 | $186.21 | $346.74 |
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 $123.03 Median $186.21 Typical High $288.40 | Professional | None | $123.03 | $186.21 | $288.40 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $870.96 Typical High $4,786.30 | Facility | None | $181.97 | $870.96 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $977.24 Typical High $1,584.89 | Professional | None | $190.55 | $977.24 | $1,584.89 |
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 $114.82 Median $186.21 Typical High $309.03 | Professional | None | $114.82 | $186.21 | $309.03 |
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 $60.26 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $23.99 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $134.90 Typical High $144.54 | Professional | 54 · Surgery only | $89.13 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $17.78 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $125.89 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $83.18 | $125.89 | $134.90 |
Where Arizona sits
The same service costs 3.9 times more in Oklahoma 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· 31st 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.