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 $128.82 Median $213.80 Typical High $223.87 | Professional | None | $128.82 | $213.80 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $158.49 Median $316.23 Typical High $380.19 | Professional | None | $158.49 | $316.23 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $257.04 Typical High $1,659.59 | Facility | None | $199.53 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $281.84 | Professional | None | $125.89 | $186.21 | $281.84 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $323.59 Typical High $1,584.89 | Facility | None | $138.04 | $323.59 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $1,023.29 Typical High $1,778.28 | Professional | None | $199.53 | $1,023.29 | $1,778.28 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $257.04 | Professional | None | $117.49 | $177.83 | $257.04 |
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 $64.57 Median $102.33 Typical High $112.20 | Professional | 52 · Reduced service | $64.57 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $40.74 Typical High $44.67 | Professional | 53 · Discontinued | $25.70 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $151.36 Typical High $165.96 | Professional | 54 · Surgery only | $97.72 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $19.50 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.88 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $141.25 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $91.20 | $141.25 | $154.88 |
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· 32nd of 51
$224
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.