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 $245.47 Median $257.04 Typical High $288.40 | Professional | None | $245.47 | $257.04 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
BCBS Arizona Setting Facility Modifier None Typical Low $85.11 Median $199.53 Typical High $524.81 | Facility | None | $85.11 | $199.53 | $524.81 |
BCBS Arizona Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $575.44 | Professional | None | $323.59 | $371.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $1,659.59 | Facility | None | $134.90 | $190.55 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $398.11 | Professional | None | $213.80 | $263.03 | $398.11 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $1,995.26 | Facility | None | $199.53 | $354.81 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,995.26 Typical High $2,089.30 | Professional | None | $229.09 | $1,995.26 | $2,089.30 |
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 $208.93 Median $245.47 Typical High $380.19 | Professional | None | $208.93 | $245.47 | $380.19 |
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 $123.03 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $194.98 | Professional | 54 · Surgery only | $186.21 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $38.90 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $177.83 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $173.78 | $177.83 | $181.97 |
Where Arizona sits
The same service costs 5.9 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· 45th of 51
$263
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.