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 $5,495.41 Typical High $8,317.64 | Facility | None | $977.24 | $5,495.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | None | $524.81 | $524.81 | $602.56 |
BCBS Arizona Setting Facility Modifier None Typical Low $891.25 Median $2,089.30 Typical High $5,495.41 | Facility | None | $891.25 | $2,089.30 | $5,495.41 |
BCBS Arizona Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,995.26 Typical High $3,801.89 | Facility | None | $977.24 | $1,995.26 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | None | $398.11 | $489.78 | $707.95 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $2,630.27 Typical High $8,912.51 | Facility | None | $575.44 | $2,630.27 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $6,918.31 | Professional | None | $407.38 | $691.83 | $6,918.31 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,244.36 | Facility | None | $812.83 | $2,951.21 | $7,244.36 |
United Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $724.44 | Professional | None | $389.05 | $467.74 | $724.44 |
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 $263.03 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $104.71 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $389.05 |
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· 9th 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.