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 $1.74 Median $5.75 Typical High $8.32 | Professional | None | $1.74 | $5.75 | $8.32 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $5.25 Typical High $6.46 | Professional | None | $4.37 | $5.25 | $6.46 |
BCBS Arizona Setting Facility Modifier None Typical Low $204.17 Median $489.78 Typical High $1,288.25 | Facility | None | $204.17 | $489.78 | $1,288.25 |
BCBS Arizona Setting Professional Modifier None Typical Low $1.41 Median $3.98 Typical High $6.17 | Professional | None | $1.41 | $3.98 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,691.53 Typical High $2,691.53 | Facility | None | $724.44 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $5.62 Typical High $7.59 | Professional | None | $1.86 | $5.62 | $7.59 |
Medica Setting Facility Modifier None Typical Low $6.31 Median $302.00 Typical High $2,041.74 | Facility | None | $6.31 | $302.00 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $5.50 Median $28.18 Typical High $186.21 | Professional | None | $5.50 | $28.18 | $186.21 |
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 $2.00 Median $5.25 Typical High $7.76 | Professional | None | $2.00 | $5.25 | $7.76 |
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 $0.87 Median $2.45 Typical High $2.88 | Professional | 52 · Reduced service | $0.87 | $2.45 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.98 Typical High $1.15 | Professional | 53 · Discontinued | $0.35 | $0.98 | $1.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.32 Median $3.16 Typical High $4.37 | Professional | 54 · Surgery only | $1.32 | $3.16 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.72 Typical High $0.87 | Professional | 55 · Aftercare only | $0.26 | $0.72 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.49 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.18 | $0.49 | $0.58 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.37 Median $4.68 Typical High $5.89 | Professional | 59 · Distinct service | $4.37 | $4.68 | $5.89 |
Where Arizona sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$6.31
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.