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 $3,715.35 Typical High $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | None | $354.81 | $354.81 | $363.08 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $676.08 | Professional | None | $309.03 | $331.13 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $3,548.13 | Facility | None | $512.86 | $1,819.70 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $616.60 | Professional | None | $309.03 | $323.59 | $616.60 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $9,332.54 | Facility | None | $512.86 | $1,905.46 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $5,128.61 | Professional | None | $316.23 | $478.63 | $5,128.61 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $676.08 | Professional | None | $309.03 | $363.08 | $676.08 |
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 $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $251.19 |
Where Arizona sits
The same service costs 6.9 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· 17th of 51
$631
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.