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 $120.23 Median $177.83 Typical High $229.09 | Professional | None | $120.23 | $177.83 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $95.50 Median $134.90 Typical High $194.98 | Professional | None | $95.50 | $134.90 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $229.09 | Facility | None | $66.07 | $123.03 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $229.09 | Professional | None | $120.23 | $169.82 | $229.09 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $316.23 Typical High $2,344.23 | Facility | None | $134.90 | $316.23 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $1,023.29 Typical High $1,548.82 | Professional | None | $173.78 | $1,023.29 | $1,548.82 |
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 $123.03 Median $162.18 Typical High $234.42 | Professional | None | $123.03 | $162.18 | $234.42 |
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 $58.88 Median $87.10 Typical High $89.13 | Professional | 52 · Reduced service | $58.88 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $34.67 Typical High $35.48 | Professional | 53 · Discontinued | $23.99 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $131.83 Typical High $134.90 | Professional | 54 · Surgery only | $89.13 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $17.38 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.02 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $123.03 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $83.18 | $123.03 | $125.89 |
Where Arizona sits
The same service costs 3.5 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· 36th of 51
$191
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.