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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $194.98 | Professional | None | $54.95 | $74.13 | $194.98 |
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 $83.18 Median $107.15 Typical High $158.49 | Professional | None | $83.18 | $107.15 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $151.36 Typical High $1,659.59 | Facility | None | $107.15 | $151.36 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $181.97 | Professional | None | $93.33 | $131.83 | $181.97 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $575.44 Typical High $2,570.40 | Facility | None | $147.91 | $575.44 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $812.83 Typical High $1,202.26 | Professional | None | $131.83 | $812.83 | $1,202.26 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $181.97 | Professional | None | $93.33 | $128.82 | $181.97 |
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 $47.86 Median $67.61 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $27.54 | Professional | 53 · Discontinued | $19.05 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $100.00 Typical High $102.33 | Professional | 54 · Surgery only | $72.44 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.95 Typical High $20.89 | Professional | 55 · Aftercare only | $14.45 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $93.33 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $67.61 | $93.33 | $95.50 |
Where Arizona sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 37th of 51
$151
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.