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 $93.33 Median $134.90 Typical High $186.21 | Professional | None | $93.33 | $134.90 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $104.71 | Professional | None | $60.26 | $79.43 | $104.71 |
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 $79.43 Median $104.71 Typical High $154.88 | Professional | None | $79.43 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $1,659.59 | Facility | None | $109.65 | $151.36 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $177.83 | Professional | None | $89.13 | $123.03 | $177.83 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $354.81 Typical High $2,041.74 | Facility | None | $125.89 | $354.81 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $794.33 Typical High $1,174.90 | Professional | None | $123.03 | $794.33 | $1,174.90 |
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 $85.11 Median $120.23 Typical High $169.82 | Professional | None | $85.11 | $120.23 | $169.82 |
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 $64.57 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.70 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $95.50 Typical High $100.00 | Professional | 54 · Surgery only | $69.18 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $19.95 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.88 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $89.13 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $64.57 | $89.13 | $93.33 |
Where Arizona sits
The same service costs 3.7 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· 36th of 51
$145
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.