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 $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,659.59 | $1,737.80 |
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 $1,479.11 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,479.11 | $2,951.21 |
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 $1,479.11 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,479.11 | $1,621.81 | $2,454.71 |
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 $1,445.44 Median $2,137.96 Typical High $16,982.44 | Professional | None | $1,445.44 | $2,137.96 | $16,982.44 |
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 $1,380.38 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,621.81 | $2,884.03 |
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 $831.76 Median $831.76 Typical High $851.14 | Professional | 52 · Reduced service | $831.76 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,202.26 |
Where Arizona sits
The same service costs 6.0 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
$1,660
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.