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 $213.80 Typical High $288.40 | Professional | None | $151.36 | $213.80 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $120.23 Median $218.78 Typical High $239.88 | Professional | None | $120.23 | $218.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $245.47 Typical High $1,659.59 | Facility | None | $173.78 | $245.47 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $281.84 | Professional | None | $128.82 | $186.21 | $281.84 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $1,380.38 Typical High $3,890.45 | Facility | None | $223.87 | $1,380.38 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $1,096.48 Typical High $2,344.23 | Professional | None | $190.55 | $1,096.48 | $2,344.23 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $281.84 | Professional | None | $120.23 | $186.21 | $281.84 |
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 $77.62 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $77.62 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $30.90 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $36.31 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.49 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $138.04 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $109.65 | $138.04 | $169.82 |
Where Arizona sits
The same service costs 4.2 times more in Wyoming 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· 27th of 51
$245
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.