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 $331.13 Median $331.13 Typical High $426.58 | Professional | None | $331.13 | $331.13 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $912.01 | Professional | None | $407.38 | $446.68 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,089.30 Typical High $2,691.53 | Facility | None | $616.60 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $741.31 | Professional | None | $380.19 | $380.19 | $741.31 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $831.76 Typical High $4,073.80 | Facility | None | $104.71 | $831.76 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $3,090.30 | Professional | None | $380.19 | $575.44 | $3,090.30 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $776.25 | Professional | None | $371.54 | $426.58 | $776.25 |
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 $165.96 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 54 · Surgery only | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $257.04 |
Where Arizona sits
The same service costs 5.0 times more in Alaska 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· 30th of 51
$550
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.