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 $512.86 Median $512.86 Typical High $588.84 | Professional | None | $512.86 | $512.86 | $588.84 |
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 $398.11 Median $398.11 Typical High $501.19 | Professional | None | $398.11 | $398.11 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,344.23 Typical High $4,570.88 | Facility | None | $691.83 | $2,344.23 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $630.96 | Professional | None | $371.54 | $478.63 | $630.96 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $11,748.98 | Facility | None | $575.44 | $1,905.46 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $676.08 Typical High $3,715.35 | Professional | None | $380.19 | $676.08 | $3,715.35 |
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 $363.08 Median $457.09 Typical High $691.83 | Professional | None | $363.08 | $457.09 | $691.83 |
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 $257.04 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 54 · Surgery only | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $380.19 |
Where Arizona sits
The same service costs 7.9 times more in Wyoming 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· 16th of 51
$851
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.