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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | None | $954.99 | $954.99 | $1,047.13 |
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 $812.83 Median $870.96 Typical High $1,778.28 | Professional | None | $812.83 | $870.96 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $3,548.13 | Facility | None | $758.58 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,659.59 | Professional | None | $831.76 | $891.25 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $2,754.23 Typical High $9,332.54 | Facility | None | $794.33 | $2,754.23 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $8,317.64 | Professional | None | $870.96 | $1,288.25 | $8,317.64 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,244.36 | Facility | None | $812.83 | $2,951.21 | $7,244.36 |
United Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,778.28 | Professional | None | $851.14 | $977.24 | $1,778.28 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Arizona sits
The same service costs 6.2 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· 34th of 51
$1,230
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.