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 $5,495.41 Typical High $8,317.64 | Facility | None | $977.24 | $5,495.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | None | $245.47 | $245.47 | $269.15 |
BCBS Arizona Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,754.23 | Facility | None | $446.68 | $1,047.13 | $2,754.23 |
BCBS Arizona Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $457.09 | Professional | None | $281.84 | $281.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,290.87 Typical High $2,691.53 | Facility | None | $724.44 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $426.58 | Professional | None | $229.09 | $257.04 | $426.58 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $2,630.27 | Facility | None | $199.53 | $398.11 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $3,467.37 | Professional | None | $251.19 | $346.74 | $3,467.37 |
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 $239.88 Median $263.03 Typical High $416.87 | Professional | None | $239.88 | $263.03 | $416.87 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where Arizona sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 45th of 51
$282
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.