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 $177.83 Median $204.17 Typical High $218.78 | Professional | None | $177.83 | $204.17 | $218.78 |
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 $141.25 Median $186.21 Typical High $363.08 | Professional | None | $141.25 | $186.21 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,995.26 Typical High $3,548.13 | Facility | None | $691.83 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $346.74 | Professional | None | $165.96 | $190.55 | $346.74 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $1,513.56 Typical High $9,332.54 | Facility | None | $223.87 | $1,513.56 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $1,380.38 Typical High $2,238.72 | Professional | None | $199.53 | $1,380.38 | $2,238.72 |
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 $173.78 Median $204.17 Typical High $371.54 | Professional | None | $173.78 | $204.17 | $371.54 |
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 $87.10 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $35.48 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $123.03 | $141.25 | $141.25 |
Where Arizona sits
The same service costs 5.9 times more in Oklahoma 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· 30th of 51
$282
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.