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 $562.34 Median $676.08 Typical High $870.96 | Professional | None | $562.34 | $676.08 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | None | $724.44 | $724.44 | $812.83 |
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 $467.74 Median $588.84 Typical High $794.33 | Professional | None | $467.74 | $588.84 | $794.33 |
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 $691.83 Typical High $933.25 | Professional | None | $575.44 | $691.83 | $933.25 |
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 $691.83 Median $4,786.30 Typical High $5,888.44 | Professional | None | $691.83 | $4,786.30 | $5,888.44 |
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 $691.83 Typical High $977.24 | Professional | None | $575.44 | $691.83 | $977.24 |
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 $281.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $478.63 |
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
$741
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.