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 $331.13 Median $426.58 Typical High $436.52 | Professional | None | $331.13 | $426.58 | $436.52 |
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 $407.38 Median $575.44 Typical High $794.33 | Professional | None | $407.38 | $575.44 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,698.24 Typical High $3,019.95 | Facility | None | $691.83 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $645.65 | Professional | None | $346.74 | $436.52 | $645.65 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,621.81 Typical High $7,943.28 | Facility | None | $467.74 | $1,621.81 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $3,090.30 Typical High $3,467.37 | Professional | None | $436.52 | $3,090.30 | $3,467.37 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $630.96 | Professional | None | $338.84 | $436.52 | $630.96 |
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 $165.96 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $251.19 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $295.12 |
Where Arizona sits
The same service costs 6.0 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· 36th of 51
$479
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.