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 $83.18 Median $128.82 Typical High $218.78 | Professional | None | $83.18 | $128.82 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | None | $93.33 | $138.04 | $138.04 |
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 $79.43 Median $107.15 Typical High $154.88 | Professional | None | $79.43 | $107.15 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $1,659.59 | Facility | None | $102.33 | $144.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $208.93 | Professional | None | $102.33 | $154.88 | $208.93 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $354.81 Typical High $2,187.76 | Facility | None | $128.82 | $354.81 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $794.33 Typical High $1,202.26 | Professional | None | $147.91 | $794.33 | $1,202.26 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $218.78 | Professional | None | $95.50 | $151.36 | $218.78 |
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 $41.69 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $41.69 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $16.60 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $61.66 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $12.30 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.32 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $91.20 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $57.54 | $91.20 | $91.20 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 59 · Distinct service | $123.03 | $123.03 | $123.03 |
Where Arizona sits
The same service costs 3.2 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· 28th of 51
$174
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.