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 $575.44 Median $575.44 Typical High $812.83 | Professional | None | $575.44 | $575.44 | $812.83 |
BCBS Arizona Setting Facility Modifier None Typical Low $616.60 Median $1,479.11 Typical High $3,801.89 | Facility | None | $616.60 | $1,479.11 | $3,801.89 |
BCBS Arizona Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $239.88 | Professional | None | $120.23 | $120.23 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $7,585.78 Typical High $14,791.08 | Facility | None | $1,548.82 | $7,585.78 | $14,791.08 |
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 $794.33 Median $977.24 Typical High $5,011.87 | Professional | None | $794.33 | $977.24 | $5,011.87 |
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 $741.31 Median $870.96 Typical High $1,202.26 | Professional | None | $741.31 | $870.96 | $1,202.26 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Where Arizona sits
The same service costs 16.2 times more in Arkansas 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· 24th of 51
$1,622
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.