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 $181.97 Median $199.53 Typical High $229.09 | Professional | None | $181.97 | $199.53 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $234.42 Median $275.42 Typical High $416.87 | Professional | None | $234.42 | $275.42 | $416.87 |
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 $162.18 Median $204.17 Typical High $316.23 | Professional | None | $162.18 | $204.17 | $316.23 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $323.59 Typical High $1,584.89 | Facility | None | $190.55 | $323.59 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $1,479.11 Typical High $1,621.81 | Professional | None | $186.21 | $1,479.11 | $1,621.81 |
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 $162.18 Median $186.21 Typical High $295.12 | Professional | None | $162.18 | $186.21 | $295.12 |
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 $89.13 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $36.31 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $125.89 | $138.04 | $138.04 |
Where Arizona sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 40th of 51
$209
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.