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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $363.08 | Professional | None | $275.42 | $288.40 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $478.63 | Professional | None | $239.88 | $323.59 | $478.63 |
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 $363.08 Median $407.38 Typical High $630.96 | Professional | None | $363.08 | $407.38 | $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 $218.78 Median $295.12 Typical High $436.52 | Professional | None | $218.78 | $295.12 | $436.52 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $2,344.23 | Facility | None | $199.53 | $354.81 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $2,187.76 Typical High $2,344.23 | Professional | None | $239.88 | $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 $213.80 Median $263.03 Typical High $416.87 | Professional | None | $213.80 | $263.03 | $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 $138.04 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $138.04 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $57.54 | Professional | 53 · Discontinued | $54.95 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $213.80 | Professional | 54 · Surgery only | $204.17 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $194.98 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $190.55 | $194.98 | $199.53 |
Where Arizona sits
The same service costs 5.6 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
$288
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.