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 $186.21 Median $269.15 Typical High $380.19 | Professional | None | $186.21 | $269.15 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | None | $120.23 | $134.90 | $134.90 |
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 $151.36 Median $208.93 Typical High $302.00 | Professional | None | $151.36 | $208.93 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $467.74 Typical High $2,187.76 | Facility | None | $371.54 | $467.74 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $354.81 | Professional | None | $177.83 | $257.04 | $354.81 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $616.60 Typical High $2,818.38 | Facility | None | $245.47 | $616.60 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,584.89 Typical High $2,290.87 | Professional | None | $263.03 | $1,584.89 | $2,290.87 |
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 $181.97 Median $245.47 Typical High $354.81 | Professional | None | $181.97 | $245.47 | $354.81 |
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 $93.33 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $199.53 Typical High $204.17 | Professional | 54 · Surgery only | $138.04 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $39.81 Typical High $40.74 | Professional | 55 · Aftercare only | $27.54 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $186.21 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $128.82 | $186.21 | $190.55 |
Where Arizona sits
The same service costs 3.6 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
$302
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.