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 $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $630.96 Median $676.08 Typical High $1,380.38 | Professional | None | $630.96 | $676.08 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $6,309.57 | Facility | None | $851.14 | $3,311.31 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,445.44 | Professional | None | $691.83 | $831.76 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $3,801.89 Typical High $16,595.87 | Facility | None | $870.96 | $3,801.89 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $6,165.95 | Professional | None | $707.95 | $1,071.52 | $6,165.95 |
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 $676.08 Median $794.33 Typical High $1,513.56 | Professional | None | $676.08 | $794.33 | $1,513.56 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Where Arizona sits
The same service costs 7.4 times more in Oklahoma 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· 31st of 51
$1,122
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.