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 $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $5,888.44 Median $11,220.18 Typical High $11,220.18 | Professional | None | $5,888.44 | $11,220.18 | $11,220.18 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $524.81 Median $3,715.35 Typical High $11,748.98 | Professional | None | $524.81 | $3,715.35 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $9,120.11 Typical High $17,782.79 | Facility | None | $1,548.82 | $9,120.11 | $17,782.79 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $7,585.78 Typical High $16,218.10 | Facility | None | $1,096.48 | $7,585.78 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $9,549.93 Median $12,302.69 Typical High $47,863.01 | Professional | None | $9,549.93 | $12,302.69 | $47,863.01 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $7,943.28 Typical High $12,302.69 | Facility | None | $1,174.90 | $7,943.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $9,332.54 Median $10,471.29 Typical High $18,197.01 | Professional | None | $9,332.54 | $10,471.29 | $18,197.01 |
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 $3,467.37 Median $5,623.41 Typical High $5,623.41 | Professional | 52 · Reduced service | $3,467.37 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $2,290.87 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,380.38 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5,248.07 Median $8,511.38 Typical High $8,511.38 | Professional | 54 · Surgery only | $5,248.07 | $8,511.38 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,047.13 Median $1,698.24 Typical High $1,698.24 | Professional | 55 · Aftercare only | $1,047.13 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $691.83 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $691.83 | $1,122.02 | $1,122.02 |
Where Arizona sits
The same service costs 16.6 times more in Indiana than in Nebraska. 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· 37th of 51
$8,913
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.