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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $72.44 | Professional | None | $45.71 | $69.18 | $72.44 |
BCBS Arizona Setting Facility Modifier None Typical Low $57.54 Median $134.90 Typical High $354.81 | Facility | None | $57.54 | $134.90 | $354.81 |
BCBS Arizona Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $128.82 | Professional | None | $56.23 | $100.00 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $67.61 Typical High $125.89 | Facility | None | $57.54 | $67.61 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $97.72 | Professional | None | $42.66 | $64.57 | $97.72 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $302.00 Typical High $1,584.89 | Facility | None | $64.57 | $302.00 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $371.54 Typical High $588.84 | Professional | None | $64.57 | $371.54 | $588.84 |
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 $42.66 Median $61.66 Typical High $93.33 | Professional | None | $42.66 | $61.66 | $93.33 |
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 $22.39 Median $30.90 Typical High $36.31 | Professional | 52 · Reduced service | $22.39 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.30 Typical High $14.45 | Professional | 53 · Discontinued | $9.12 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $46.77 Typical High $54.95 | Professional | 54 · Surgery only | $33.88 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.12 Typical High $10.96 | Professional | 55 · Aftercare only | $6.76 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.17 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.47 | $6.17 | $7.24 |
Where Arizona sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 40th of 51
$72.44
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.