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 $169.82 Median $213.80 Typical High $288.40 | Professional | None | $169.82 | $213.80 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $229.09 Median $426.58 Typical High $524.81 | Professional | None | $229.09 | $426.58 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $2,691.53 | Facility | None | $295.12 | $416.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $346.74 | Professional | None | $138.04 | $194.98 | $346.74 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $602.56 Typical High $1,862.09 | Facility | None | $208.93 | $602.56 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $1,380.38 Typical High $2,290.87 | Professional | None | $177.83 | $1,380.38 | $2,290.87 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $309.03 | Professional | None | $107.15 | $177.83 | $309.03 |
7 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 $85.11 Median $107.15 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $57.54 | Professional | 53 · Discontinued | $33.88 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $128.82 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $147.91 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $120.23 | $147.91 | $199.53 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 79 · Unrelated procedure after surgery | $363.08 | $363.08 | $363.08 |
Where Arizona sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 28th of 51
$282
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.