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 $107.15 Median $131.83 Typical High $194.98 | Professional | None | $107.15 | $131.83 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $158.49 | Professional | None | $107.15 | $138.04 | $158.49 |
BCBS Arizona Setting Facility Modifier None Typical Low $51.29 Median $123.03 Typical High $316.23 | Facility | None | $51.29 | $123.03 | $316.23 |
BCBS Arizona Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $199.53 | Professional | None | $102.33 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $165.96 | Facility | None | $66.07 | $89.13 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $213.80 | Professional | None | $123.03 | $154.88 | $213.80 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $309.03 Typical High $1,862.09 | Facility | None | $128.82 | $309.03 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $870.96 Typical High $1,096.48 | Professional | None | $134.90 | $870.96 | $1,096.48 |
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 $114.82 Median $141.25 Typical High $213.80 | Professional | None | $114.82 | $141.25 | $213.80 |
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 $53.70 Median $63.10 Typical High $66.07 | Professional | 52 · Reduced service | $53.70 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.12 Typical High $26.30 | Professional | 53 · Discontinued | $21.38 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $95.50 Typical High $100.00 | Professional | 54 · Surgery only | $79.43 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $19.95 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.59 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.72 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $89.13 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $74.13 | $89.13 | $93.33 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 79 · Unrelated procedure after surgery | $144.54 | $144.54 | $144.54 |
Where Arizona sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 44th of 51
$145
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.