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 $107.15 Median $165.96 Typical High $229.09 | Professional | None | $107.15 | $165.96 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $87.10 Median $123.03 Typical High $181.97 | Professional | None | $87.10 | $123.03 | $181.97 |
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 $109.65 Median $158.49 Typical High $208.93 | Professional | None | $109.65 | $158.49 | $208.93 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $316.23 Typical High $1,584.89 | Facility | None | $128.82 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $912.01 Typical High $1,445.44 | Professional | None | $162.18 | $912.01 | $1,445.44 |
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 $109.65 Median $151.36 Typical High $213.80 | Professional | None | $109.65 | $151.36 | $213.80 |
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 $53.70 Median $79.43 Typical High $83.18 | Professional | 52 · Reduced service | $53.70 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $31.62 Typical High $33.11 | Professional | 53 · Discontinued | $21.38 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $120.23 Typical High $125.89 | Professional | 54 · Surgery only | $79.43 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.99 Typical High $25.12 | Professional | 55 · Aftercare only | $15.85 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.85 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.72 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $112.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $74.13 | $112.20 | $117.49 |
Where Arizona sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 37th of 51
$178
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.