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 $199.53 Median $245.47 Typical High $338.84 | Professional | None | $199.53 | $245.47 | $338.84 |
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 $165.96 Median $208.93 Typical High $288.40 | Professional | None | $165.96 | $208.93 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,659.59 | Facility | None | $512.86 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $331.13 | Professional | None | $190.55 | $239.88 | $331.13 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $616.60 Typical High $3,981.07 | Facility | None | $257.04 | $616.60 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $1,698.24 Typical High $2,089.30 | Professional | None | $239.88 | $1,698.24 | $2,089.30 |
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 $194.98 Median $239.88 Typical High $331.13 | Professional | None | $194.98 | $239.88 | $331.13 |
7 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 $100.00 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $39.81 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $147.91 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $29.51 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $138.04 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 59 · Distinct service | $257.04 | $257.04 | $257.04 |
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· 36th of 51
$288
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.