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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | None | $501.19 | $501.19 | $575.44 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $954.99 | Professional | None | $426.58 | $457.09 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $3,630.78 | Facility | None | $851.14 | $1,995.26 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $870.96 | Professional | None | $436.52 | $467.74 | $870.96 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $2,754.23 Typical High $9,549.93 | Facility | None | $575.44 | $2,754.23 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $4,168.69 | Professional | None | $457.09 | $676.08 | $4,168.69 |
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 $436.52 Median $512.86 Typical High $912.01 | Professional | None | $436.52 | $512.86 | $912.01 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Arizona sits
The same service costs 10.0 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· 19th of 51
$851
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.