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 $181.97 Median $257.04 Typical High $331.13 | Professional | None | $181.97 | $257.04 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $147.91 Median $199.53 Typical High $288.40 | Professional | None | $147.91 | $199.53 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $204.17 Typical High $380.19 | Facility | None | $66.07 | $204.17 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $338.84 | Professional | None | $173.78 | $251.19 | $338.84 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $575.44 Typical High $2,570.40 | Facility | None | $257.04 | $575.44 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $1,548.82 Typical High $2,187.76 | Professional | None | $251.19 | $1,548.82 | $2,187.76 |
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 $177.83 Median $239.88 Typical High $346.74 | Professional | None | $177.83 | $239.88 | $346.74 |
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 $91.20 Median $125.89 Typical High $128.82 | Professional | 52 · Reduced service | $91.20 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $36.31 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $134.90 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $27.54 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $18.20 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $125.89 | $177.83 | $177.83 |
Where Arizona sits
The same service costs 3.9 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
$282
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.