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 $83.18 Median $131.83 Typical High $190.55 | Professional | None | $83.18 | $131.83 | $190.55 |
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 $64.57 Median $109.65 Typical High $169.82 | Professional | None | $64.57 | $109.65 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $131.83 Typical High $239.88 | Facility | None | $66.07 | $131.83 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $194.98 | Professional | None | $81.28 | $131.83 | $194.98 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $316.23 Typical High $1,584.89 | Facility | None | $107.15 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $707.95 Typical High $1,348.96 | Professional | None | $141.25 | $707.95 | $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 $83.18 Median $125.89 Typical High $190.55 | Professional | None | $83.18 | $125.89 | $190.55 |
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 $41.69 Median $70.79 Typical High $77.62 | Professional | 52 · Reduced service | $41.69 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $28.18 Typical High $30.90 | Professional | 53 · Discontinued | $16.60 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $107.15 Typical High $117.49 | Professional | 54 · Surgery only | $61.66 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $21.38 Typical High $23.44 | Professional | 55 · Aftercare only | $12.30 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $14.13 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.32 | $14.13 | $15.49 |
Where Arizona sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 38th of 51
$155
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.