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 $144.54 Median $194.98 Typical High $263.03 | Professional | None | $144.54 | $194.98 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $117.49 | Professional | None | $95.50 | $107.15 | $117.49 |
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 $125.89 Median $158.49 Typical High $229.09 | Professional | None | $125.89 | $158.49 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,659.59 | Facility | None | $512.86 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $257.04 | Professional | None | $138.04 | $186.21 | $257.04 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $851.14 Typical High $3,981.07 | Facility | None | $208.93 | $851.14 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $1,230.27 Typical High $1,659.59 | Professional | None | $181.97 | $1,230.27 | $1,659.59 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $251.19 | Professional | None | $138.04 | $177.83 | $251.19 |
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 $72.44 Median $95.50 Typical High $97.72 | Professional | 52 · Reduced service | $72.44 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $28.84 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $109.65 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.05 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.45 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $134.90 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $102.33 | $134.90 | $134.90 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 51 · Multiple procedures | $77.62 | $77.62 | $77.62 |
Where Arizona sits
The same service costs 4.6 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
$219
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.