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 $74.13 Median $204.17 Typical High $316.23 | Professional | None | $74.13 | $204.17 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS Arizona Setting Facility Modifier None Typical Low $85.11 Median $363.08 Typical High $537.03 | Facility | None | $85.11 | $363.08 | $537.03 |
BCBS Arizona Setting Professional Modifier None Typical Low $85.11 Median $295.12 Typical High $537.03 | Professional | None | $85.11 | $295.12 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $218.78 Typical High $457.09 | Professional | None | $77.62 | $218.78 | $457.09 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $912.01 Typical High $2,344.23 | Facility | None | $81.28 | $912.01 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $1,148.15 Typical High $2,691.53 | Professional | None | $239.88 | $1,148.15 | $2,691.53 |
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 $75.86 Median $199.53 Typical High $380.19 | Professional | None | $75.86 | $199.53 | $380.19 |
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 $36.31 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $36.31 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $33.88 Typical High $53.70 | Professional | 53 · Discontinued | $14.79 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $54.95 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $25.70 Typical High $40.74 | Professional | 55 · Aftercare only | $10.96 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $16.98 Typical High $26.92 | Professional | 56 · Pre-op care only | $7.41 | $16.98 | $26.92 |
Where Arizona sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 21st of 51
$269
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.