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 $53.70 Median $93.33 Typical High $141.25 | Professional | None | $53.70 | $93.33 | $141.25 |
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 $42.66 Median $83.18 Typical High $128.82 | Professional | None | $42.66 | $83.18 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $190.55 | Facility | None | $66.07 | $104.71 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $134.90 | Professional | None | $52.48 | $89.13 | $134.90 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $316.23 Typical High $1,584.89 | Facility | None | $77.62 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $512.86 Typical High $1,023.29 | Professional | None | $93.33 | $512.86 | $1,023.29 |
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 $53.70 Median $87.10 Typical High $141.25 | Professional | None | $53.70 | $87.10 | $141.25 |
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 $26.92 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $26.92 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $19.05 Typical High $23.44 | Professional | 53 · Discontinued | $10.96 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $70.79 Typical High $87.10 | Professional | 54 · Surgery only | $40.74 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $8.13 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.55 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.37 | $9.55 | $11.75 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 59 · Distinct service | $100.00 | $100.00 | $100.00 |
Where Arizona sits
The same service costs 3.2 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· 24th of 51
$117
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.