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 $575.44 Median $676.08 Typical High $977.24 | Professional | None | $575.44 | $676.08 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $707.95 | Professional | None | $562.34 | $691.83 | $707.95 |
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 $478.63 Median $602.56 Typical High $758.58 | Professional | None | $478.63 | $602.56 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,691.53 | Facility | None | $758.58 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $912.01 | Professional | None | $575.44 | $676.08 | $912.01 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $954.99 Typical High $5,623.41 | Facility | None | $524.81 | $954.99 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $7,079.46 | Professional | None | $645.65 | $794.33 | $7,079.46 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $954.99 | Professional | None | $575.44 | $676.08 | $954.99 |
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 $288.40 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $467.74 | $467.74 |
Where Arizona sits
The same service costs 4.6 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· 40th of 51
$724
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.