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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $794.33 | Professional | None | $616.60 | $794.33 | $794.33 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,318.26 | Professional | None | $691.83 | $1,023.29 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $6,309.57 | Facility | None | $851.14 | $3,311.31 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,047.13 | Professional | None | $630.96 | $758.58 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $1,621.81 Typical High $16,595.87 | Facility | None | $691.83 | $1,621.81 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $5,011.87 Typical High $6,456.54 | Professional | None | $741.31 | $5,011.87 | $6,456.54 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $977.24 | Professional | None | $588.84 | $724.44 | $977.24 |
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 $309.03 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $549.54 |
Where Arizona sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 37th of 51
$813
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.