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 $100.00 Median $123.03 Typical High $165.96 | Professional | None | $100.00 | $123.03 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $151.36 | Professional | None | $109.65 | $120.23 | $151.36 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $134.90 | Professional | None | $81.28 | $120.23 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $1,659.59 | Facility | None | $81.28 | $114.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $158.49 | Professional | None | $89.13 | $109.65 | $158.49 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $331.13 Typical High $2,951.21 | Facility | None | $117.49 | $331.13 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $758.58 Typical High $954.99 | Professional | None | $102.33 | $758.58 | $954.99 |
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 $83.18 Median $104.71 Typical High $162.18 | Professional | None | $83.18 | $104.71 | $162.18 |
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 $53.70 Median $64.57 Typical High $67.61 | Professional | 52 · Reduced service | $53.70 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $26.92 | Professional | 53 · Discontinued | $21.38 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $102.33 | Professional | 54 · Surgery only | $79.43 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $91.20 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $74.13 | $91.20 | $95.50 |
Where Arizona sits
The same service costs 4.0 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· 35th of 51
$135
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.