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 $2,137.96 Median $2,137.96 Typical High $2,187.76 | Professional | None | $2,137.96 | $2,137.96 | $2,187.76 |
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 $1,862.09 Median $1,862.09 Typical High $3,715.35 | Professional | None | $1,862.09 | $1,862.09 | $3,715.35 |
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 $1,819.70 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,041.74 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $5,495.41 | Facility | None | $104.71 | $1,096.48 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $25,703.96 | Professional | None | $1,819.70 | $2,570.40 | $25,703.96 |
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 $1,778.28 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,778.28 | $2,041.74 | $3,467.37 |
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 $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $436.52 | Professional | 53 · Discontinued | $426.58 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,513.56 |
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· 40th of 51
$2,138
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.