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 $6,309.57 Typical High $10,715.19 | Facility | None | $977.24 | $6,309.57 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | None | $588.84 | $660.69 | $660.69 |
BCBS 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 Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $478.63 | Professional | None | $239.88 | $239.88 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $15,848.93 Typical High $30,902.95 | Facility | None | $1,548.82 | $15,848.93 | $30,902.95 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $6,918.31 Typical High $13,803.84 | Facility | None | $851.14 | $6,918.31 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $2,951.21 | Professional | None | $588.84 | $741.31 | $2,951.21 |
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 $549.54 Median $645.65 Typical High $933.25 | Professional | None | $549.54 | $645.65 | $933.25 |
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 $281.84 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $66.07 |
Where Arizona sits
The same service costs 27.5 times more in Oklahoma 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· 18th of 51
$2,399
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.