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 $194.98 Median $204.17 Typical High $288.40 | Professional | None | $194.98 | $204.17 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $489.78 | Professional | None | $223.87 | $489.78 | $489.78 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $436.52 | Professional | None | $251.19 | $281.84 | $436.52 |
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 $173.78 Median $208.93 Typical High $316.23 | Professional | None | $173.78 | $208.93 | $316.23 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $2,344.23 | Facility | None | $194.98 | $323.59 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $1,584.89 Typical High $1,659.59 | Professional | None | $186.21 | $1,584.89 | $1,659.59 |
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 $165.96 Median $194.98 Typical High $302.00 | Professional | None | $165.96 | $194.98 | $302.00 |
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 $95.50 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $151.36 Typical High $154.88 | Professional | 54 · Surgery only | $144.54 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $30.90 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.50 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $141.25 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $134.90 | $141.25 | $144.54 |
Where Arizona sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 41st of 51
$219
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.