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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,737.80 | $1,737.80 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $4,168.69 Typical High $7,943.28 | Facility | None | $2,398.83 | $4,168.69 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,548.82 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,467.37 Typical High $8,912.51 | Facility | None | $891.25 | $3,467.37 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $14,454.40 | Professional | None | $1,348.96 | $1,949.84 | $14,454.40 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $8,317.64 | Facility | None | $977.24 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,548.82 | $2,398.83 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,023.29 |
Where Arizona sits
The same service costs 19.5 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· 38th of 51
$1,738
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.