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 $61.66 Median $85.11 Typical High $109.65 | Professional | None | $61.66 | $85.11 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $50.12 Median $66.07 Typical High $95.50 | Professional | None | $50.12 | $66.07 | $95.50 |
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 $58.88 Median $83.18 Typical High $112.20 | Professional | None | $58.88 | $83.18 | $112.20 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $316.23 Typical High $1,584.89 | Facility | None | $87.10 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $524.81 Typical High $741.31 | Professional | None | $81.28 | $524.81 | $741.31 |
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 $58.88 Median $79.43 Typical High $112.20 | Professional | None | $58.88 | $79.43 | $112.20 |
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 $30.90 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $30.90 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.98 Typical High $17.38 | Professional | 53 · Discontinued | $12.30 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $63.10 Typical High $64.57 | Professional | 54 · Surgery only | $46.77 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $9.33 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.17 | $8.32 | $8.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $58.88 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $43.65 | $58.88 | $60.26 |
Where Arizona sits
The same service costs 3.8 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· 42nd of 51
$91.20
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.