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 $6,309.57 Typical High $9,772.37 | Facility | None | $977.24 | $6,309.57 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,000.00 | $1,318.26 |
BCBS Arizona Setting Facility Modifier None Typical Low $3,235.94 Median $7,585.78 Typical High $19,952.62 | Facility | None | $3,235.94 | $7,585.78 | $19,952.62 |
BCBS Arizona Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,949.84 | Professional | None | $977.24 | $977.24 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $7,943.28 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,943.28 | $11,481.54 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,122.02 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,265.80 Typical High $10,715.19 | Facility | None | $1,023.29 | $4,265.80 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $8,709.64 | Professional | None | $1,023.29 | $1,445.44 | $8,709.64 |
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 $977.24 Median $1,122.02 Typical High $1,862.09 | Professional | None | $977.24 | $1,122.02 | $1,862.09 |
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 $501.19 Median $501.19 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | 54 · Surgery only | $741.31 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $794.33 |
Where Arizona sits
The same service costs 8.9 times more in Oklahoma 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· 6th of 51
$3,020
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.