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 $158.49 Median $208.93 Typical High $281.84 | Professional | None | $158.49 | $208.93 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $147.91 | Professional | None | $100.00 | $100.00 | $147.91 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $239.88 | Professional | None | $138.04 | $173.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $2,187.76 | Facility | None | $630.96 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $275.42 | Professional | None | $147.91 | $199.53 | $275.42 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $933.25 Typical High $3,981.07 | Facility | None | $229.09 | $933.25 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $1,348.96 Typical High $1,778.28 | Professional | None | $194.98 | $1,348.96 | $1,778.28 |
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 $151.36 Median $194.98 Typical High $269.15 | Professional | None | $151.36 | $194.98 | $269.15 |
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 $79.43 Median $102.33 Typical High $104.71 | Professional | 52 · Reduced service | $79.43 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $40.74 Typical High $41.69 | Professional | 53 · Discontinued | $31.62 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $112.20 | $144.54 | $144.54 |
Where Arizona sits
The same service costs 4.7 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· 32nd of 51
$240
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.