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 $77.62 Median $123.03 Typical High $162.18 | Professional | None | $77.62 | $123.03 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | None | $97.72 | $112.20 | $112.20 |
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 $63.10 Median $93.33 Typical High $141.25 | Professional | None | $63.10 | $93.33 | $141.25 |
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 $77.62 Median $117.49 Typical High $154.88 | Professional | None | $77.62 | $117.49 | $154.88 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $316.23 Typical High $1,584.89 | Facility | None | $107.15 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $660.69 Typical High $1,122.02 | Professional | None | $123.03 | $660.69 | $1,122.02 |
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 $75.86 Median $112.20 Typical High $162.18 | Professional | None | $75.86 | $112.20 | $162.18 |
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 $38.02 Median $60.26 Typical High $64.57 | Professional | 52 · Reduced service | $38.02 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.99 Typical High $25.70 | Professional | 53 · Discontinued | $15.49 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $89.13 Typical High $95.50 | Professional | 54 · Surgery only | $57.54 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $11.48 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.02 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.76 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $83.18 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $53.70 | $83.18 | $89.13 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $109.65 Median $141.25 Typical High $147.91 | Professional | 79 · Unrelated procedure after surgery | $109.65 | $141.25 | $147.91 |
Where Arizona sits
The same service costs 3.5 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· 32nd of 51
$135
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.