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 $138.04 Median $177.83 Typical High $257.04 | Professional | None | $138.04 | $177.83 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $107.15 | Professional | None | $70.79 | $91.20 | $107.15 |
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 $120.23 Median $151.36 Typical High $208.93 | Professional | None | $120.23 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $1,659.59 | Facility | None | $134.90 | $186.21 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $239.88 | Professional | None | $131.83 | $169.82 | $239.88 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $851.14 Typical High $3,019.95 | Facility | None | $194.98 | $851.14 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $1,174.90 Typical High $1,548.82 | Professional | None | $169.82 | $1,174.90 | $1,548.82 |
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 $134.90 Median $165.96 Typical High $234.42 | Professional | None | $134.90 | $165.96 | $234.42 |
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 $69.18 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $131.83 Typical High $134.90 | Professional | 54 · Surgery only | $104.71 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.30 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $123.03 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $97.72 | $123.03 | $125.89 |
Where Arizona sits
The same service costs 4.0 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· 40th of 51
$195
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.