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 $83.18 Median $104.71 Typical High $114.82 | Professional | None | $83.18 | $104.71 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $100.00 Median $154.88 Typical High $208.93 | Professional | None | $100.00 | $154.88 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $91.20 Typical High $169.82 | Facility | None | $66.07 | $91.20 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $165.96 | Professional | None | $85.11 | $109.65 | $165.96 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $851.14 Typical High $2,511.89 | Facility | None | $117.49 | $851.14 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $676.08 Typical High $1,445.44 | Professional | None | $100.00 | $676.08 | $1,445.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $151.36 | Professional | None | $77.62 | $100.00 | $151.36 |
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 $45.71 Typical High $57.54 | Professional | 52 · Reduced service | $41.69 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $22.91 | Professional | 53 · Discontinued | $16.60 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $69.18 Typical High $85.11 | Professional | 54 · Surgery only | $61.66 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.80 Typical High $16.98 | Professional | 55 · Aftercare only | $12.30 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $64.57 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $57.54 | $64.57 | $79.43 |
Where Arizona sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 40th of 51
$117
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.