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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $263.03 | Professional | None | $151.36 | $234.42 | $263.03 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $389.05 | Professional | None | $177.83 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $257.04 Typical High $2,187.76 | Facility | None | $186.21 | $257.04 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $316.23 | Professional | None | $154.88 | $223.87 | $316.23 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $831.76 Typical High $2,511.89 | Facility | None | $234.42 | $831.76 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $1,202.26 Typical High $1,862.09 | Professional | None | $234.42 | $1,202.26 | $1,862.09 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $288.40 | Professional | None | $154.88 | $213.80 | $288.40 |
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 $75.86 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $112.20 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $22.39 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $162.18 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $104.71 | $162.18 | $162.18 |
Where Arizona sits
The same service costs 3.6 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· 33rd of 51
$245
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.