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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $114.82 | Professional | None | $38.90 | $74.13 | $114.82 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $107.15 | Professional | None | $30.90 | $69.18 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $173.78 | Facility | None | $66.07 | $93.33 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $114.82 | Professional | None | $38.02 | $72.44 | $114.82 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $316.23 Typical High $1,584.89 | Facility | None | $56.23 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $436.52 Typical High $851.14 | Professional | None | $77.62 | $436.52 | $851.14 |
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 $38.02 Median $67.61 Typical High $117.49 | Professional | None | $38.02 | $67.61 | $117.49 |
6 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 $19.50 Median $34.67 Typical High $48.98 | Professional | 52 · Reduced service | $19.50 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $19.50 | Professional | 53 · Discontinued | $7.76 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $52.48 Typical High $74.13 | Professional | 54 · Surgery only | $29.51 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.47 Typical High $14.79 | Professional | 55 · Aftercare only | $5.89 | $10.47 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $3.89 | $6.92 | $9.77 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 59 · Distinct service | $85.11 | $85.11 | $85.11 |
Where Arizona sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 23rd of 51
$97.72
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.