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 $213.80 Median $3,715.35 Typical High $5,623.41 | Facility | None | $213.80 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $177.83 | Professional | None | $93.33 | $109.65 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $125.89 | Professional | None | $79.43 | $97.72 | $125.89 |
BCBS Arizona Setting Facility Modifier None Typical Low $74.13 Median $177.83 Typical High $467.74 | Facility | None | $74.13 | $177.83 | $467.74 |
BCBS Arizona Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $134.90 | Professional | None | $83.18 | $104.71 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $173.78 | Facility | None | $66.07 | $95.50 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $144.54 | Professional | None | $89.13 | $109.65 | $144.54 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $338.84 Typical High $2,344.23 | Facility | None | $109.65 | $338.84 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $794.33 Typical High $954.99 | Professional | None | $95.50 | $794.33 | $954.99 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $147.91 | Professional | None | $81.28 | $100.00 | $147.91 |
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 $46.77 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $46.77 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $18.62 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 54 · Surgery only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $14.13 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $66.07 | $77.62 | $77.62 |
Where Arizona sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 43rd of 51
$115
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.