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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | None | $257.04 | $288.40 | $309.03 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $575.44 | Professional | None | $316.23 | $389.05 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,023.29 Typical High $2,691.53 | Facility | None | $724.44 | $1,023.29 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $478.63 | Professional | None | $263.03 | $295.12 | $478.63 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $1,513.56 Typical High $4,786.30 | Facility | None | $331.13 | $1,513.56 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $2,137.96 Typical High $3,090.30 | Professional | None | $281.84 | $2,137.96 | $3,090.30 |
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 $251.19 Median $288.40 Typical High $446.68 | Professional | None | $251.19 | $288.40 | $446.68 |
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 $128.82 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $204.17 |
Where Arizona sits
The same service costs 6.8 times more in Alaska than in Utah. 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· 37th of 51
$324
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.