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 $3,548.13 Median $3,548.13 Typical High $3,890.45 | Professional | None | $3,548.13 | $3,548.13 | $3,890.45 |
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 $4,265.80 Median $4,265.80 Typical High $6,760.83 | Professional | None | $4,265.80 | $4,265.80 | $6,760.83 |
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 $3,311.31 Median $4,073.80 Typical High $5,370.32 | Professional | None | $3,311.31 | $4,073.80 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $5,248.07 | Facility | None | $104.71 | $1,096.48 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $3,235.94 Median $5,888.44 Typical High $28,840.32 | Professional | None | $3,235.94 | $5,888.44 | $28,840.32 |
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 $3,090.30 Median $3,548.13 Typical High $5,011.87 | Professional | None | $3,090.30 | $3,548.13 | $5,011.87 |
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 $1,778.28 Median $1,778.28 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | 53 · Discontinued | $707.95 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,691.53 |
Where Arizona sits
The same service costs 21.9 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· 38th of 51
$3,890
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.