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 $60.26 Median $112.20 Typical High $151.36 | Professional | None | $60.26 | $112.20 | $151.36 |
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 $72.44 Median $177.83 Typical High $251.19 | Professional | None | $72.44 | $177.83 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $2,691.53 | Facility | None | $147.91 | $204.17 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $177.83 | Professional | None | $66.07 | $120.23 | $177.83 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $851.14 Typical High $2,951.21 | Facility | None | $138.04 | $851.14 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $831.76 Typical High $1,230.27 | Professional | None | $120.23 | $831.76 | $1,230.27 |
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 $60.26 Median $109.65 Typical High $154.88 | Professional | None | $60.26 | $109.65 | $154.88 |
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 $30.20 Median $53.70 Typical High $75.86 | Professional | 52 · Reduced service | $30.20 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $21.38 Typical High $30.20 | Professional | 53 · Discontinued | $12.02 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $79.43 Typical High $114.82 | Professional | 54 · Surgery only | $44.67 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $16.22 Typical High $22.91 | Professional | 55 · Aftercare only | $8.91 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.03 | $10.72 | $15.14 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $60.26 | $60.26 | $60.26 |
Where Arizona sits
The same service costs 3.7 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· 32nd of 51
$141
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.