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 $229.09 Median $346.74 Typical High $363.08 | Professional | None | $229.09 | $346.74 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $616.60 | Professional | None | $288.40 | $457.09 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $2,691.53 | Facility | None | $239.88 | $338.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $501.19 | Professional | None | $234.42 | $323.59 | $501.19 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,380.38 Typical High $3,801.89 | Facility | None | $346.74 | $1,380.38 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $1,905.46 Typical High $2,884.03 | Professional | None | $331.13 | $1,905.46 | $2,884.03 |
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 $223.87 Median $323.59 Typical High $478.63 | Professional | None | $223.87 | $323.59 | $478.63 |
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 $114.82 Median $162.18 Typical High $169.82 | Professional | 52 · Reduced service | $114.82 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $46.77 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.91 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $162.18 | $223.87 | $239.88 |
Where Arizona sits
The same service costs 4.3 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· 36th of 51
$363
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.