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 $109.65 Median $181.97 Typical High $194.98 | Professional | None | $109.65 | $181.97 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
BCBS Arizona Setting Facility Modifier None Typical Low $33.88 Median $81.28 Typical High $213.80 | Facility | None | $33.88 | $81.28 | $213.80 |
BCBS Arizona Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $446.68 | Professional | None | $138.04 | $245.47 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $269.15 | Professional | None | $112.20 | $177.83 | $269.15 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $851.14 Typical High $2,511.89 | Facility | None | $158.49 | $851.14 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $851.14 Typical High $1,412.54 | Professional | None | $181.97 | $851.14 | $1,412.54 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $281.84 | Professional | None | $112.20 | $181.97 | $281.84 |
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 $54.95 Median $87.10 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $128.82 Typical High $134.90 | Professional | 54 · Surgery only | $83.18 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $120.23 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $77.62 | $120.23 | $125.89 |
Where Arizona sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 35th of 51
$200
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.