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 $5,495.41 Typical High $8,317.64 | Facility | None | $977.24 | $5,495.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $1,230.27 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,230.27 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,398.83 | $5,011.87 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,698.24 | Professional | None | $933.25 | $1,071.52 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,466.84 Typical High $9,120.11 | Facility | None | $1,023.29 | $4,466.84 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $8,511.38 | Professional | None | $912.01 | $1,288.25 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,096.48 | $6,309.57 | $9,772.37 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,659.59 | Professional | None | $912.01 | $1,023.29 | $1,659.59 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Arizona sits
The same service costs 8.7 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
$1,230
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.