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 $85.11 Median $125.89 Typical High $147.91 | Professional | None | $85.11 | $125.89 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $67.61 Median $97.72 Typical High $141.25 | Professional | None | $67.61 | $97.72 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $204.17 | Facility | None | $66.07 | $109.65 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $165.96 | Professional | None | $83.18 | $123.03 | $165.96 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $316.23 Typical High $2,344.23 | Facility | None | $107.15 | $316.23 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $707.95 Typical High $1,122.02 | Professional | None | $125.89 | $707.95 | $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 $83.18 Median $117.49 Typical High $165.96 | Professional | None | $83.18 | $117.49 | $165.96 |
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 $41.69 Median $61.66 Typical High $64.57 | Professional | 52 · Reduced service | $41.69 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $24.55 Typical High $26.30 | Professional | 53 · Discontinued | $16.98 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $93.33 Typical High $97.72 | Professional | 54 · Surgery only | $63.10 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $12.59 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.51 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $87.10 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $58.88 | $87.10 | $91.20 |
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
$138
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.