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 $64.57 Median $107.15 Typical High $158.49 | Professional | None | $64.57 | $107.15 | $158.49 |
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 $51.29 Median $93.33 Typical High $147.91 | Professional | None | $51.29 | $93.33 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $213.80 | Facility | None | $66.07 | $117.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $158.49 | Professional | None | $63.10 | $104.71 | $158.49 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $316.23 Typical High $1,584.89 | Facility | None | $91.20 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $588.84 Typical High $1,148.15 | Professional | None | $112.20 | $588.84 | $1,148.15 |
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 $63.10 Median $97.72 Typical High $162.18 | Professional | None | $63.10 | $97.72 | $162.18 |
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 $32.36 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $32.36 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $12.88 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $47.86 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $9.55 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.46 | $11.48 | $13.18 |
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· 31st of 51
$132
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.