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 $1,445.44 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,445.44 | $1,445.44 | $1,659.59 |
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 $1,202.26 Median $1,288.25 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,288.25 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $5,623.41 | Facility | None | $758.58 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,318.26 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $14,454.40 | Facility | None | $933.25 | $3,801.89 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $11,481.54 | Professional | None | $1,318.26 | $1,949.84 | $11,481.54 |
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 $1,288.25 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,479.11 | $2,691.53 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Arizona sits
The same service costs 5.8 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· 37th of 51
$1,738
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.