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 $104.71 Median $165.96 Typical High $213.80 | Professional | None | $104.71 | $165.96 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $128.82 Median $275.42 Typical High $331.13 | Professional | None | $128.82 | $275.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $1,659.59 | Facility | None | $169.82 | $223.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $239.88 | Professional | None | $102.33 | $151.36 | $239.88 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $851.14 Typical High $2,511.89 | Facility | None | $151.36 | $851.14 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $851.14 Typical High $1,584.89 | Professional | None | $154.88 | $851.14 | $1,584.89 |
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 $138.04 Typical High $208.93 | Professional | None | $93.33 | $138.04 | $208.93 |
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 $52.48 Median $77.62 Typical High $97.72 | Professional | 52 · Reduced service | $52.48 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $117.49 Typical High $144.54 | Professional | 54 · Surgery only | $79.43 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.44 Typical High $29.51 | Professional | 55 · Aftercare only | $15.85 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.49 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $109.65 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $74.13 | $109.65 | $134.90 |
Where Arizona sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 31st of 51
$191
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.