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 $158.49 Median $199.53 Typical High $275.42 | Professional | None | $158.49 | $199.53 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | None | $100.00 | $117.49 | $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 $134.90 Median $165.96 Typical High $229.09 | Professional | None | $134.90 | $165.96 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $204.17 Typical High $1,659.59 | Facility | None | $144.54 | $204.17 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $263.03 | Professional | None | $147.91 | $190.55 | $263.03 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $575.44 Typical High $2,570.40 | Facility | None | $218.78 | $575.44 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $1,348.96 Typical High $1,698.24 | Professional | None | $190.55 | $1,348.96 | $1,698.24 |
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 $151.36 Median $190.55 Typical High $263.03 | Professional | None | $151.36 | $190.55 | $263.03 |
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 $77.62 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $31.62 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.85 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $138.04 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $109.65 | $138.04 | $138.04 |
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· 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.