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 $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,905.46 | $1,949.84 |
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 $1,659.59 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,659.59 | $1,659.59 | $3,311.31 |
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 $1,698.24 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,862.09 | $2,818.38 |
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 $1,659.59 Median $2,290.87 Typical High $18,620.87 | Professional | None | $1,659.59 | $2,290.87 | $18,620.87 |
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 $1,584.89 Median $1,819.70 Typical High $3,311.31 | Professional | None | $1,584.89 | $1,819.70 | $3,311.31 |
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 $954.99 Median $954.99 Typical High $977.24 | Professional | 52 · Reduced service | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 53 · Discontinued | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,380.38 |
Where Arizona sits
The same service costs 5.5 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· 42nd of 51
$1,905
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.