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 $5,495.41 Typical High $8,317.64 | Facility | None | $977.24 | $5,495.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $776.25 | Professional | None | $512.86 | $537.03 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $562.34 | Professional | None | $426.58 | $457.09 | $562.34 |
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 $398.11 Median $478.63 Typical High $537.03 | Professional | None | $398.11 | $478.63 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $363.08 Typical High $1,659.59 | Facility | None | $281.84 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $776.25 | Professional | None | $467.74 | $501.19 | $776.25 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $707.95 Typical High $3,890.45 | Facility | None | $363.08 | $707.95 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $3,715.35 Typical High $3,801.89 | Professional | None | $501.19 | $3,715.35 | $3,801.89 |
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 $478.63 Median $524.81 Typical High $724.44 | Professional | None | $478.63 | $524.81 | $724.44 |
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 $257.04 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $371.54 | $416.87 |
Where Arizona sits
The same service costs 6.2 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· 41st of 51
$562
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.