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 $95.50 Median $151.36 Typical High $208.93 | Professional | None | $95.50 | $151.36 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $177.83 | Professional | None | $117.49 | $144.54 | $177.83 |
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 $77.62 Median $114.82 Typical High $169.82 | Professional | None | $77.62 | $114.82 | $169.82 |
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 $97.72 Median $144.54 Typical High $190.55 | Professional | None | $97.72 | $144.54 | $190.55 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $316.23 Typical High $2,187.76 | Facility | None | $117.49 | $316.23 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $831.76 Typical High $1,348.96 | Professional | None | $144.54 | $831.76 | $1,348.96 |
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 $97.72 Median $138.04 Typical High $194.98 | Professional | None | $97.72 | $138.04 | $194.98 |
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 $47.86 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $47.86 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $19.50 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $109.65 Typical High $114.82 | Professional | 54 · Surgery only | $72.44 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $21.88 Typical High $22.91 | Professional | 55 · Aftercare only | $14.45 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.55 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $102.33 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $67.61 | $102.33 | $107.15 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $67.61 Median $123.03 Typical High $162.18 | Professional | 79 · Unrelated procedure after surgery | $67.61 | $123.03 | $162.18 |
Where Arizona sits
The same service costs 3.4 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· 33rd of 51
$166
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.