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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $1,659.59 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,995.26 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,318.26 Typical High $3,311.31 | Facility | None | $933.25 | $1,318.26 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $3,311.31 | Professional | None | $2,238.72 | $2,454.71 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $1,258.93 Typical High $15,135.61 | Facility | None | $501.19 | $1,258.93 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $19,952.62 | Professional | None | $2,238.72 | $2,818.38 | $19,952.62 |
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 $2,137.96 Median $2,511.89 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,511.89 | $3,548.13 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,621.81 |
Where Arizona sits
The same service costs 15.8 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· 46th of 51
$2,344
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.