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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $380.19 | Professional | None | $186.21 | $281.84 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $354.81 | Professional | None | $109.65 | $194.98 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $1,737.80 | Facility | None | $512.86 | $977.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $407.38 | Professional | None | $165.96 | $245.47 | $407.38 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $933.25 Typical High $5,248.07 | Facility | None | $281.84 | $933.25 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $2,187.76 Typical High $2,187.76 | Professional | None | $257.04 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $398.11 | Professional | None | $165.96 | $245.47 | $398.11 |
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 $93.33 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $48.98 Typical High $56.23 | Professional | 53 · Discontinued | $37.15 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $24.55 | $28.18 |
Where Arizona sits
The same service costs 3.1 times more in Alaska than in New York. 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· 25th of 51
$331
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.