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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $562.34 | Professional | None | $398.11 | $501.19 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $977.24 | Professional | None | $501.19 | $691.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $6,309.57 | Facility | None | $691.83 | $3,162.28 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $776.25 | Professional | None | $407.38 | $501.19 | $776.25 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,621.81 Typical High $16,218.10 | Facility | None | $524.81 | $1,621.81 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $4,897.79 Typical High $5,011.87 | Professional | None | $501.19 | $4,897.79 | $5,011.87 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $758.58 | Professional | None | $407.38 | $501.19 | $758.58 |
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 $199.53 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $199.53 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $281.84 | $346.74 | $346.74 |
Where Arizona sits
The same service costs 5.5 times more in Alaska than in Texas. 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
$550
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.