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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
BCBS Arizona Setting Facility Modifier None Typical Low $891.25 Median $2,089.30 Typical High $5,495.41 | Facility | None | $891.25 | $2,089.30 | $5,495.41 |
BCBS Arizona Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $2,137.96 | Professional | None | $977.24 | $1,047.13 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $3,467.37 Typical High $6,309.57 | Facility | None | $977.24 | $3,467.37 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,288.25 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $16,595.87 | Facility | None | $933.25 | $3,801.89 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $9,549.93 | Professional | None | $1,096.48 | $1,698.24 | $9,549.93 |
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 $1,047.13 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,230.27 | $2,344.23 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Arizona sits
The same service costs 6.6 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· 34th of 51
$1,622
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.