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 $537.03 Median $660.69 Typical High $891.25 | Professional | None | $537.03 | $660.69 | $891.25 |
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 $446.68 Median $562.34 Typical High $776.25 | Professional | None | $446.68 | $562.34 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $2,344.23 | Facility | None | $691.83 | $1,318.26 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $912.01 | Professional | None | $524.81 | $645.65 | $912.01 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $954.99 Typical High $5,623.41 | Facility | None | $524.81 | $954.99 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $4,570.88 Typical High $5,754.40 | Professional | None | $660.69 | $4,570.88 | $5,754.40 |
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 $524.81 Median $660.69 Typical High $891.25 | Professional | None | $524.81 | $660.69 | $891.25 |
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 $263.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $53.70 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $467.74 | $467.74 |
Where Arizona sits
The same service costs 4.2 times more in Alaska than in Texas. 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· 39th of 51
$724
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.