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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $190.55 | Professional | None | $91.20 | $128.82 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $154.88 | Professional | None | $85.11 | $107.15 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $234.42 | Facility | None | $66.07 | $125.89 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $177.83 | Professional | None | $91.20 | $123.03 | $177.83 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $323.59 Typical High $1,584.89 | Facility | None | $112.20 | $323.59 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $794.33 Typical High $1,122.02 | Professional | None | $120.23 | $794.33 | $1,122.02 |
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 $117.49 Typical High $169.82 | Professional | None | $81.28 | $117.49 | $169.82 |
7 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 $45.71 Median $64.57 Typical High $66.07 | Professional | 52 · Reduced service | $45.71 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.70 Typical High $26.30 | Professional | 53 · Discontinued | $18.62 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $69.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.12 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $91.20 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $64.57 | $91.20 | $91.20 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 59 · Distinct service | $123.03 | $123.03 | $123.03 |
Where Arizona sits
The same service costs 4.1 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· 38th of 51
$141
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.