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 $5,888.44 Typical High $10,232.93 | Facility | None | $977.24 | $5,888.44 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | None | $776.25 | $776.25 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $645.65 Median $691.83 Typical High $1,445.44 | Professional | None | $645.65 | $691.83 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,467.37 Typical High $6,309.57 | Facility | None | $1,174.90 | $3,467.37 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,318.26 | Professional | None | $676.08 | $707.95 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $4,677.35 Typical High $16,218.10 | Facility | None | $851.14 | $4,677.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $5,623.41 | Professional | None | $724.44 | $1,047.13 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,096.48 | $6,309.57 | $9,772.37 |
United Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,412.54 | Professional | None | $691.83 | $794.33 | $1,412.54 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
Where Arizona sits
The same service costs 7.2 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· 29th of 51
$1,096
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.