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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $190.55 | Professional | None | $81.28 | $134.90 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $154.88 | Professional | None | $70.79 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $131.83 Typical High $1,659.59 | Facility | None | $95.50 | $131.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $186.21 | Professional | None | $83.18 | $131.83 | $186.21 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $831.76 Typical High $3,801.89 | Facility | None | $138.04 | $831.76 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $3,162.28 Typical High $3,630.78 | Professional | None | $138.04 | $3,162.28 | $3,630.78 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $194.98 | Professional | None | $87.10 | $138.04 | $194.98 |
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 $40.74 Median $63.10 Typical High $69.18 | Professional | 52 · Reduced service | $40.74 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.12 Typical High $27.54 | Professional | 53 · Discontinued | $16.22 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $95.50 Typical High $102.33 | Professional | 54 · Surgery only | $60.26 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $19.05 Typical High $20.42 | Professional | 55 · Aftercare only | $12.02 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.59 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.13 | $12.59 | $13.80 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 58 · Staged procedure | $74.13 | $74.13 | $74.13 |
Where Arizona sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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
$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.