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 $707.95 Median $870.96 Typical High $1,174.90 | Professional | None | $707.95 | $870.96 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $588.84 Median $724.44 Typical High $1,000.00 | Professional | None | $588.84 | $724.44 | $1,000.00 |
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 $741.31 Median $891.25 Typical High $1,230.27 | Professional | None | $741.31 | $891.25 | $1,230.27 |
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 $870.96 Median $6,025.60 Typical High $7,413.10 | Professional | None | $870.96 | $6,025.60 | $7,413.10 |
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 $724.44 Median $891.25 Typical High $1,230.27 | Professional | None | $724.44 | $891.25 | $1,230.27 |
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 $354.81 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $602.56 |
Where Arizona sits
The same service costs 4.5 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· 41st of 51
$933
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.