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 $57.54 Median $97.72 Typical High $186.21 | Professional | None | $57.54 | $97.72 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
BCBS Arizona Setting Facility Modifier None Typical Low $58.88 Median $138.04 Typical High $363.08 | Facility | None | $58.88 | $138.04 | $363.08 |
BCBS Arizona Setting Professional Modifier None Typical Low $41.69 Median $138.04 Typical High $234.42 | Professional | None | $41.69 | $138.04 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $181.97 | Professional | None | $56.23 | $93.33 | $181.97 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $323.59 Typical High $1,584.89 | Facility | None | $89.13 | $323.59 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $602.56 Typical High $1,148.15 | Professional | None | $93.33 | $602.56 | $1,148.15 |
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 $53.70 Median $91.20 Typical High $181.97 | Professional | None | $53.70 | $91.20 | $181.97 |
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 $30.90 Median $44.67 Typical High $85.11 | Professional | 52 · Reduced service | $30.90 | $44.67 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $17.78 Typical High $33.88 | Professional | 53 · Discontinued | $12.30 | $17.78 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $67.61 Typical High $128.82 | Professional | 54 · Surgery only | $46.77 | $67.61 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.49 Typical High $25.70 | Professional | 55 · Aftercare only | $9.33 | $13.49 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $16.98 |
Where Arizona sits
The same service costs 4.0 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· 24th of 51
$138
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.