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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $489.78 | Professional | None | $295.12 | $295.12 | $489.78 |
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 $346.74 Median $371.54 Typical High $776.25 | Professional | None | $346.74 | $371.54 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $3,548.13 | Facility | None | $758.58 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $575.44 | Professional | None | $281.84 | $302.00 | $575.44 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $1,862.09 Typical High $9,549.93 | Facility | None | $489.78 | $1,862.09 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $2,511.89 | Professional | None | $288.40 | $426.58 | $2,511.89 |
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 $269.15 Median $316.23 Typical High $602.56 | Professional | None | $269.15 | $316.23 | $602.56 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $204.17 |
Where Arizona sits
The same service costs 11.2 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· 13th of 51
$646
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.