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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $91.20 | Professional | None | $47.86 | $58.88 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $61.66 | Professional | None | $45.71 | $58.88 | $61.66 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $66.07 | Professional | None | $39.81 | $50.12 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $83.18 | Professional | None | $45.71 | $60.26 | $83.18 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $316.23 Typical High $2,187.76 | Facility | None | $63.10 | $316.23 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $501.19 | Professional | None | $56.23 | $125.89 | $501.19 |
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 $45.71 Median $57.54 Typical High $83.18 | Professional | None | $45.71 | $57.54 | $83.18 |
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 $23.99 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $23.99 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $9.55 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $44.67 Typical High $44.67 | Professional | 54 · Surgery only | $36.31 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $7.24 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.79 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $41.69 Typical High $41.69 | Professional | 78 · Unplanned return to OR | $33.88 | $41.69 | $41.69 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $45.71 Median $51.29 Typical High $67.61 | Professional | 59 · Distinct service | $45.71 | $51.29 | $67.61 |
Where Arizona sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 38th of 51
$66.07
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.