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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | None | $288.40 | $346.74 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | None | $263.03 | $295.12 | $323.59 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $346.74 | Professional | None | $257.04 | $309.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,187.76 | Facility | None | $288.40 | $426.58 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $407.38 | Professional | None | $245.47 | $302.00 | $407.38 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $676.08 Typical High $2,754.23 | Facility | None | $338.84 | $676.08 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $2,344.23 Typical High $2,511.89 | Professional | None | $257.04 | $2,344.23 | $2,511.89 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $436.52 | Professional | None | $239.88 | $288.40 | $436.52 |
8 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 $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $223.87 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $239.88 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 50 · Both sides | $489.78 | $489.78 | $489.78 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 79 · Unrelated procedure after surgery | $467.74 | $467.74 | $467.74 |
Where Arizona sits
The same service costs 5.8 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· 36th of 51
$347
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.