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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,511.89 | Professional | None | $2,187.76 | $2,187.76 | $2,511.89 |
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 $2,454.71 Median $2,630.27 Typical High $5,495.41 | Professional | None | $2,454.71 | $2,630.27 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,511.89 | $4,365.16 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $5,128.61 | Facility | None | $104.71 | $1,096.48 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $3,388.44 Typical High $17,782.79 | Professional | None | $2,137.96 | $3,388.44 | $17,782.79 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,454.71 | $4,677.35 |
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 $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $446.68 | Professional | 53 · Discontinued | $436.52 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,548.82 |
Where Arizona sits
The same service costs 10.0 times more in Alaska than in Texas. 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· 42nd of 51
$2,455
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.