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 $549.54 Median $549.54 Typical High $602.56 | Professional | None | $549.54 | $549.54 | $602.56 |
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 $446.68 Median $478.63 Typical High $1,000.00 | Professional | None | $446.68 | $478.63 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,202.26 Typical High $2,691.53 | Facility | None | $912.01 | $1,202.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,023.29 | Professional | None | $524.81 | $549.54 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $3,630.78 Typical High $6,918.31 | Facility | None | $676.08 | $3,630.78 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $10,964.78 | Professional | None | $537.03 | $794.33 | $10,964.78 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $8,317.64 | Facility | None | $977.24 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,122.02 | Professional | None | $524.81 | $602.56 | $1,122.02 |
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 $275.42 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $275.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $416.87 |
Where Arizona sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 19th of 51
$1,000
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.