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 $47.86 Median $87.10 Typical High $147.91 | Professional | None | $47.86 | $87.10 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
BCBS Arizona Setting Facility Modifier None Typical Low $75.86 Median $177.83 Typical High $467.74 | Facility | None | $75.86 | $177.83 | $467.74 |
BCBS Arizona Setting Professional Modifier None Typical Low $38.90 Median $85.11 Typical High $147.91 | Professional | None | $38.90 | $85.11 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $70.79 Typical High $131.83 | Facility | None | $60.26 | $70.79 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $104.71 Typical High $151.36 | Professional | None | $57.54 | $104.71 | $151.36 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $302.00 Typical High $1,584.89 | Facility | None | $79.43 | $302.00 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $407.38 Typical High $758.58 | Professional | None | $100.00 | $407.38 | $758.58 |
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 $57.54 Median $95.50 Typical High $154.88 | Professional | None | $57.54 | $95.50 | $154.88 |
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 $23.99 Median $37.15 Typical High $43.65 | Professional | 52 · Reduced service | $23.99 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.79 Typical High $17.38 | Professional | 53 · Discontinued | $9.55 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $56.23 Typical High $64.57 | Professional | 54 · Surgery only | $35.48 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $13.18 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.41 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.79 | $7.41 | $8.71 |
Where Arizona sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 28th of 51
$112
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.