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 $3,715.35 Typical High $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $3,548.13 | Professional | None | $3,235.94 | $3,467.37 | $3,548.13 |
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 $3,090.30 Median $3,090.30 Typical High $6,025.60 | Professional | None | $3,090.30 | $3,090.30 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $5,128.61 | Professional | None | $3,090.30 | $3,388.44 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $5,128.61 | Facility | None | $104.71 | $1,096.48 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $26,915.35 | Professional | None | $3,019.95 | $4,168.69 | $26,915.35 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $5,754.40 | Professional | None | $2,884.03 | $3,388.44 | $5,754.40 |
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 $1,737.80 Median $1,737.80 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | 53 · Discontinued | $691.83 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,570.40 | $2,570.40 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,398.83 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,398.83 | $2,511.89 |
Where Arizona sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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
$3,388
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.