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 $208.93 Median $331.13 Typical High $446.68 | Professional | None | $208.93 | $331.13 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $194.98 | Professional | None | $169.82 | $186.21 | $194.98 |
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 $169.82 Median $251.19 Typical High $371.54 | Professional | None | $169.82 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $316.23 Typical High $2,187.76 | Facility | None | $213.80 | $316.23 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $426.58 | Professional | None | $229.09 | $309.03 | $426.58 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $2,187.76 | Facility | None | $199.53 | $398.11 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $1,778.28 Typical High $2,884.03 | Professional | None | $309.03 | $1,778.28 | $2,884.03 |
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 $218.78 Median $302.00 Typical High $436.52 | Professional | None | $218.78 | $302.00 | $436.52 |
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 $104.71 Median $162.18 Typical High $165.96 | Professional | 52 · Reduced service | $104.71 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $64.57 Typical High $66.07 | Professional | 53 · Discontinued | $41.69 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $158.49 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $31.62 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $32.36 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.89 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $147.91 | $223.87 | $234.42 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 79 · Unrelated procedure after surgery | $177.83 | $177.83 | $177.83 |
Where Arizona sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 40th of 51
$339
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.