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 $128.82 Median $165.96 Typical High $234.42 | Professional | None | $128.82 | $165.96 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $162.18 | Professional | None | $100.00 | $123.03 | $162.18 |
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 $109.65 Median $138.04 Typical High $190.55 | Professional | None | $109.65 | $138.04 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $1,659.59 | Facility | None | $131.83 | $181.97 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $223.87 | Professional | None | $123.03 | $162.18 | $223.87 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $575.44 Typical High $2,691.53 | Facility | None | $181.97 | $575.44 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $1,096.48 Typical High $1,445.44 | Professional | None | $158.49 | $1,096.48 | $1,445.44 |
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 $123.03 Median $158.49 Typical High $218.78 | Professional | None | $123.03 | $158.49 | $218.78 |
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 $64.57 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $64.57 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $125.89 Typical High $125.89 | Professional | 54 · Surgery only | $95.50 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $19.50 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.88 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $89.13 | $117.49 | $117.49 |
Where Arizona sits
The same service costs 3.9 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
$182
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.