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 $169.82 Median $239.88 Typical High $338.84 | Professional | None | $169.82 | $239.88 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $269.15 | Professional | None | $107.15 | $134.90 | $269.15 |
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 $138.04 Median $186.21 Typical High $269.15 | Professional | None | $138.04 | $186.21 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $1,659.59 | Facility | None | $173.78 | $229.09 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $323.59 | Professional | None | $162.18 | $234.42 | $323.59 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $575.44 Typical High $3,467.37 | Facility | None | $239.88 | $575.44 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $1,445.44 Typical High $2,089.30 | Professional | None | $234.42 | $1,445.44 | $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 $165.96 Median $223.87 Typical High $316.23 | Professional | None | $165.96 | $223.87 | $316.23 |
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 $83.18 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $83.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $33.88 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $181.97 | Professional | 54 · Surgery only | $125.89 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $25.12 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.98 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $165.96 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $117.49 | $165.96 | $169.82 |
Where Arizona sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 37th of 51
$263
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.