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 $102.33 Median $134.90 Typical High $154.88 | Professional | None | $102.33 | $134.90 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $234.42 | Professional | None | $120.23 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $1,659.59 | Facility | None | $100.00 | $141.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $190.55 | Professional | None | $100.00 | $128.82 | $190.55 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $776.25 Typical High $3,890.45 | Facility | None | $144.54 | $776.25 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $831.76 Typical High $1,096.48 | Professional | None | $131.83 | $831.76 | $1,096.48 |
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 $93.33 Median $125.89 Typical High $165.96 | Professional | None | $93.33 | $125.89 | $165.96 |
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 $51.29 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $51.29 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $20.42 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 54 · Surgery only | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $15.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $72.44 | $93.33 | $93.33 |
Where Arizona sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$138
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.