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 $239.88 Median $380.19 Typical High $380.19 | Professional | None | $239.88 | $380.19 | $380.19 |
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 $229.09 Median $229.09 Typical High $457.09 | Professional | None | $229.09 | $229.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $4,265.80 | Facility | None | $1,548.82 | $2,398.83 | $4,265.80 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $7,244.36 | Facility | None | $549.54 | $2,398.83 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $1,819.70 | Professional | None | $223.87 | $281.84 | $1,819.70 |
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 $213.80 Median $239.88 Typical High $416.87 | Professional | None | $213.80 | $239.88 | $416.87 |
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 $120.23 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $47.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.99 | $38.02 | $38.02 |
Where Arizona sits
The same service costs 10.7 times more in Colorado than in Maine. 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· 9th of 51
$1,778
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.