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 $407.38 Median $676.08 Typical High $676.08 | Professional | None | $407.38 | $676.08 | $676.08 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,230.27 Median $2,951.21 Typical High $7,762.47 | Facility | None | $1,230.27 | $2,951.21 | $7,762.47 |
BCBS Arizona Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $776.25 | Professional | None | $398.11 | $398.11 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $8,128.31 Typical High $15,488.17 | Facility | None | $1,548.82 | $8,128.31 | $15,488.17 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,918.31 Typical High $13,803.84 | Facility | None | $954.99 | $6,918.31 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $3,162.28 | Professional | None | $302.00 | $398.11 | $3,162.28 |
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 $302.00 Median $338.84 Typical High $645.65 | Professional | None | $302.00 | $338.84 | $645.65 |
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 $199.53 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $199.53 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $79.43 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $58.88 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $39.81 | $67.61 | $67.61 |
Where Arizona sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 13th of 51
$2,455
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.