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 $269.15 Median $288.40 Typical High $323.59 | Professional | None | $269.15 | $288.40 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $331.13 | Professional | None | $194.98 | $331.13 | $331.13 |
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 $346.74 Median $416.87 Typical High $630.96 | Professional | None | $346.74 | $416.87 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $281.84 | Facility | None | $66.07 | $151.36 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $436.52 | Professional | None | $245.47 | $295.12 | $436.52 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $1,737.80 | Facility | None | $199.53 | $354.81 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $2,187.76 Typical High $2,344.23 | Professional | None | $263.03 | $2,187.76 | $2,344.23 |
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 $234.42 Median $269.15 Typical High $416.87 | Professional | None | $234.42 | $269.15 | $416.87 |
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 $134.90 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $134.90 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $57.54 Typical High $58.88 | Professional | 53 · Discontinued | $53.70 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $218.78 | Professional | 54 · Surgery only | $204.17 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $199.53 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $190.55 | $199.53 | $204.17 |
Where Arizona sits
The same service costs 5.8 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· 43rd of 51
$295
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.