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 $158.49 Median $158.49 Typical High $177.83 | Professional | None | $158.49 | $158.49 | $177.83 |
BCBS Arizona Setting Facility Modifier None Typical Low $169.82 Median $407.38 Typical High $1,071.52 | Facility | None | $169.82 | $407.38 | $1,071.52 |
BCBS Arizona Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $467.74 | Professional | None | $213.80 | $229.09 | $467.74 |
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 $190.55 Median $190.55 Typical High $346.74 | Professional | None | $190.55 | $190.55 | $346.74 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $323.59 Typical High $1,905.46 | Facility | None | $158.49 | $323.59 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $1,348.96 | Professional | None | $169.82 | $302.00 | $1,348.96 |
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 $165.96 Median $263.03 Typical High $389.05 | Professional | None | $165.96 | $263.03 | $389.05 |
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 $77.62 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Arizona sits
The same service costs 7.2 times more in Oklahoma than in 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· 31st of 51
$275
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.