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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $346.74 | Professional | None | $275.42 | $275.42 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | None | $269.15 | $295.12 | $295.12 |
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 $281.84 Median $281.84 Typical High $436.52 | Professional | None | $281.84 | $281.84 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,162.28 Typical High $6,309.57 | Facility | None | $758.58 | $3,162.28 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $416.87 | Professional | None | $257.04 | $288.40 | $416.87 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $1,905.46 Typical High $16,595.87 | Facility | None | $478.63 | $1,905.46 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $2,630.27 | Professional | None | $257.04 | $436.52 | $2,630.27 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,570.40 Typical High $5,623.41 | Facility | None | $794.33 | $2,570.40 | $5,623.41 |
United Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $398.11 | Professional | None | $245.47 | $281.84 | $398.11 |
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 $138.04 Median $138.04 Typical High $144.54 | Professional | 52 · Reduced service | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 53 · Discontinued | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $218.78 | Professional | 54 · Surgery only | $204.17 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $204.17 |
Where Arizona sits
The same service costs 5.5 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· 45th of 51
$288
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.