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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $138.04 | Professional | None | $91.20 | $91.20 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | None | $45.71 | $47.86 | $50.12 |
BCBS Arizona Setting Facility Modifier None Typical Low $112.20 Median $478.63 Typical High $724.44 | Facility | None | $112.20 | $478.63 | $724.44 |
BCBS Arizona Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $151.36 | Professional | None | $77.62 | $77.62 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $218.78 | Professional | None | $95.50 | $109.65 | $218.78 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $1,230.27 Typical High $2,344.23 | Facility | None | $100.00 | $1,230.27 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $776.25 Typical High $776.25 | Professional | None | $100.00 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,949.84 Typical High $2,454.71 | Facility | None | $812.83 | $1,949.84 | $2,454.71 |
United Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $204.17 | Professional | None | $95.50 | $112.20 | $204.17 |
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 $45.71 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 54 · Surgery only | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.79 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $10.00 |
Where Arizona sits
The same service costs 3.5 times more in Wisconsin than in New York. 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· 41st of 51
$112
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.