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 $4,677.35 Typical High $17,782.79 | Facility | None | $977.24 | $4,677.35 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,659.59 | $1,659.59 | $1,819.70 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,737.80 Median $4,168.69 Typical High $10,964.78 | Facility | None | $1,737.80 | $4,168.69 | $10,964.78 |
BCBS Arizona Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,995.26 | $1,995.26 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $4,786.30 | Facility | None | $602.56 | $4,786.30 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,862.09 | $2,570.40 |
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 $1,513.56 Median $2,691.53 Typical High $13,182.57 | Professional | None | $1,513.56 | $2,691.53 | $13,182.57 |
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 $1,412.54 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,737.80 | $2,398.83 |
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 $891.25 | Professional | 52 · Reduced service | $831.76 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | 53 · Discontinued | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,258.93 |
Where Arizona sits
The same service costs 5.4 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· 39th of 51
$1,862
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.