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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | None | $549.54 | $549.54 | $660.69 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,122.02 | Professional | None | $512.86 | $549.54 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $6,309.57 | Facility | None | $851.14 | $3,311.31 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,047.13 | Professional | None | $524.81 | $630.96 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $4,466.84 Typical High $16,218.10 | Facility | None | $776.25 | $4,466.84 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $4,786.30 | Professional | None | $524.81 | $794.33 | $4,786.30 |
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 $512.86 Median $602.56 Typical High $1,148.15 | Professional | None | $512.86 | $602.56 | $1,148.15 |
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 $269.15 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 54 · Surgery only | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $389.05 |
Where Arizona sits
The same service costs 8.1 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· 21st 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.