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 $2,344.23 Median $5,248.07 Typical High $9,332.54 | Facility | None | $2,344.23 | $5,248.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | None | $537.03 | $741.31 | $741.31 |
BCBS Arizona Setting Facility Modifier None Typical Low $138.04 Median $331.13 Typical High $870.96 | Facility | None | $138.04 | $331.13 | $870.96 |
BCBS Arizona Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $131.83 | Professional | None | $67.61 | $67.61 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $6,760.83 | Facility | None | $1,548.82 | $2,511.89 | $6,760.83 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $2,238.72 Typical High $7,244.36 | Facility | None | $741.31 | $2,238.72 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $3,715.35 | Professional | None | $501.19 | $660.69 | $3,715.35 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,244.36 | Facility | None | $812.83 | $2,951.21 | $7,244.36 |
United Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $954.99 | Professional | None | $501.19 | $562.34 | $954.99 |
5 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 $269.15 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $269.15 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $107.15 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $398.11 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $79.43 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $53.70 | $74.13 | $74.13 |
Where Arizona sits
The same service costs 10.2 times more in Texas than in New York. 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
$871
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.