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 $3,715.35 Typical High $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $199.53 Typical High $204.17 | Professional | None | $61.66 | $199.53 | $204.17 |
BCBS Arizona Setting Facility Modifier None Typical Low $234.42 Median $562.34 Typical High $1,479.11 | Facility | None | $234.42 | $562.34 | $1,479.11 |
BCBS Arizona Setting Professional Modifier None Typical Low $54.95 Median $186.21 Typical High $338.84 | Professional | None | $54.95 | $186.21 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,398.83 Typical High $2,691.53 | Facility | None | $524.81 | $2,398.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $208.93 Typical High $380.19 | Professional | None | $74.13 | $208.93 | $380.19 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $309.03 Typical High $1,905.46 | Facility | None | $107.15 | $309.03 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $1,737.80 | Professional | None | $263.03 | $575.44 | $1,737.80 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $371.54 | Professional | None | $79.43 | $190.55 | $371.54 |
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 $30.90 Median $51.29 Typical High $102.33 | Professional | 52 · Reduced service | $30.90 | $51.29 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $20.42 Typical High $40.74 | Professional | 53 · Discontinued | $12.30 | $20.42 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $75.86 Typical High $151.36 | Professional | 54 · Surgery only | $46.77 | $75.86 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.14 Typical High $30.20 | Professional | 55 · Aftercare only | $9.33 | $15.14 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.23 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.17 | $10.23 | $20.42 |
Where Arizona sits
The same service costs 4.5 times more in Oklahoma 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· 16th of 51
$263
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.