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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | None | $398.11 | $398.11 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $1,047.13 | Professional | None | $478.63 | $512.86 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,995.26 Typical High $3,548.13 | Facility | None | $691.83 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $794.33 | Professional | None | $389.05 | $407.38 | $794.33 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,905.46 Typical High $9,549.93 | Facility | None | $524.81 | $1,905.46 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $3,388.44 | Professional | None | $398.11 | $602.56 | $3,388.44 |
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 $380.19 Median $446.68 Typical High $851.14 | Professional | None | $380.19 | $446.68 | $851.14 |
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 $199.53 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $281.84 |
Where Arizona sits
The same service costs 8.9 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· 18th of 51
$759
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.