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 $245.47 Median $331.13 Typical High $380.19 | Professional | None | $245.47 | $331.13 | $380.19 |
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 $181.97 Median $346.74 Typical High $371.54 | Professional | None | $181.97 | $346.74 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $3,801.89 | Facility | None | $245.47 | $346.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $446.68 | Professional | None | $213.80 | $302.00 | $446.68 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,513.56 Typical High $3,630.78 | Facility | None | $346.74 | $1,513.56 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $1,737.80 Typical High $3,548.13 | Professional | None | $309.03 | $1,737.80 | $3,548.13 |
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 $194.98 Median $295.12 Typical High $446.68 | Professional | None | $194.98 | $295.12 | $446.68 |
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 $123.03 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $123.03 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $48.98 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $181.97 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $169.82 | $223.87 | $269.15 |
Where Arizona sits
The same service costs 3.9 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· 31st of 51
$380
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.