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 $363.08 Median $1,258.93 Typical High $1,258.93 | Professional | None | $363.08 | $1,258.93 | $1,258.93 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $295.12 Median $1,000.00 Typical High $1,995.26 | Professional | None | $295.12 | $1,000.00 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,691.53 | Facility | None | $1,047.13 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $1,148.15 Typical High $2,884.03 | Professional | None | $338.84 | $1,148.15 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $3,090.30 Typical High $8,511.38 | Facility | None | $707.95 | $3,090.30 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $5,495.41 Typical High $20,417.38 | Professional | None | $1,548.82 | $5,495.41 | $20,417.38 |
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 $389.05 Median $1,258.93 Typical High $2,884.03 | Professional | None | $389.05 | $1,258.93 | $2,884.03 |
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 $181.97 Median $524.81 Typical High $616.60 | Professional | 52 · Reduced service | $181.97 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $208.93 Typical High $251.19 | Professional | 53 · Discontinued | $72.44 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $269.15 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $158.49 Typical High $186.21 | Professional | 55 · Aftercare only | $54.95 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $104.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $36.31 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $251.19 | $724.44 | $870.96 |
Where Arizona sits
The same service costs 4.9 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· 26th of 51
$1,479
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.