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 $186.21 Median $239.88 Typical High $323.59 | Professional | None | $186.21 | $239.88 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $218.78 Median $316.23 Typical High $602.56 | Professional | None | $218.78 | $316.23 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,691.53 | Facility | None | $758.58 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $398.11 | Professional | None | $190.55 | $245.47 | $398.11 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $954.99 Typical High $5,623.41 | Facility | None | $263.03 | $954.99 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $1,584.89 Typical High $2,089.30 | Professional | None | $213.80 | $1,584.89 | $2,089.30 |
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 $186.21 Median $223.87 Typical High $426.58 | Professional | None | $186.21 | $223.87 | $426.58 |
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 $93.33 Median $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $141.25 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $28.18 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $162.18 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $131.83 | $162.18 | $169.82 |
Where Arizona sits
The same service costs 4.7 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· 26th of 51
$331
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.