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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $478.63 | Professional | None | $213.80 | $338.84 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $398.11 | Professional | None | $295.12 | $302.00 | $398.11 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $380.19 | Professional | None | $177.83 | $257.04 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $512.86 Typical High $2,691.53 | Facility | None | $407.38 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $436.52 | Professional | None | $234.42 | $338.84 | $436.52 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $2,884.03 | Facility | None | $199.53 | $398.11 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $1,819.70 Typical High $2,951.21 | Professional | None | $338.84 | $1,819.70 | $2,951.21 |
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 $223.87 Median $316.23 Typical High $457.09 | Professional | None | $223.87 | $316.23 | $457.09 |
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 $107.15 Median $162.18 Typical High $169.82 | Professional | 52 · Reduced service | $107.15 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $66.07 Typical High $67.61 | Professional | 53 · Discontinued | $42.66 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $158.49 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $32.36 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.38 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $147.91 | $229.09 | $239.88 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $181.97 Median $181.97 Typical High $302.00 | Professional | 79 · Unrelated procedure after surgery | $181.97 | $181.97 | $302.00 |
Where Arizona sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$372
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.