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 $323.59 Median $323.59 Typical High $446.68 | Professional | None | $323.59 | $323.59 | $446.68 |
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 $389.05 Median $416.87 Typical High $851.14 | Professional | None | $389.05 | $416.87 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $6,309.57 | Facility | None | $794.33 | $3,162.28 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $645.65 | Professional | None | $331.13 | $338.84 | $645.65 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $4,466.84 Typical High $16,218.10 | Facility | None | $660.69 | $4,466.84 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $2,818.38 | Professional | None | $331.13 | $501.19 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,096.48 | $6,309.57 | $9,772.37 |
United Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $707.95 | Professional | None | $323.59 | $371.54 | $707.95 |
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 $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $229.09 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 51 · Multiple procedures | $295.12 | $295.12 | $295.12 |
Where Arizona sits
The same service costs 9.3 times more in Kansas than in Utah. 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· 14th of 51
$741
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.