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 $151.36 Median $245.47 Typical High $354.81 | Professional | None | $151.36 | $245.47 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $125.89 Median $257.04 Typical High $275.42 | Professional | None | $125.89 | $257.04 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $1,659.59 | Facility | None | $204.17 | $269.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $338.84 | Professional | None | $138.04 | $234.42 | $338.84 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $891.25 Typical High $3,890.45 | Facility | None | $281.84 | $891.25 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $1,174.90 Typical High $2,238.72 | Professional | None | $239.88 | $1,174.90 | $2,238.72 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $309.03 | Professional | None | $128.82 | $223.87 | $309.03 |
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 $81.28 Median $107.15 Typical High $141.25 | Professional | 52 · Reduced service | $81.28 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $32.36 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $123.03 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $24.55 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $151.36 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $114.82 | $151.36 | $199.53 |
Where Arizona sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 26th of 51
$282
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.