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 $446.68 Median $446.68 Typical High $575.44 | Professional | None | $446.68 | $446.68 | $575.44 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $831.76 | Professional | None | $380.19 | $407.38 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,905.46 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $758.58 | Professional | None | $380.19 | $407.38 | $758.58 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $4,466.84 Typical High $16,218.10 | Facility | None | $660.69 | $4,466.84 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $3,235.94 | Professional | None | $398.11 | $588.84 | $3,235.94 |
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 $380.19 Median $446.68 Typical High $812.83 | Professional | None | $380.19 | $446.68 | $812.83 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $309.03 |
Where Arizona sits
The same service costs 9.5 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· 11th of 51
$1,000
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.