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 $4,677.35 Typical High $7,943.28 | Facility | None | $977.24 | $4,677.35 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,819.70 Typical High $3,630.78 | Professional | None | $281.84 | $1,819.70 | $3,630.78 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $181.97 Median $1,288.25 Typical High $4,073.80 | Professional | None | $181.97 | $1,288.25 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,951.21 Typical High $6,760.83 | Facility | None | $1,548.82 | $2,951.21 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $2,754.23 Typical High $4,677.35 | Professional | None | $251.19 | $2,754.23 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $2,818.38 Typical High $6,309.57 | Facility | None | $537.03 | $2,818.38 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $3,467.37 Median $9,120.11 Typical High $22,908.68 | Professional | None | $3,467.37 | $9,120.11 | $22,908.68 |
United Setting Facility Modifier None Typical Low $812.83 Median $3,715.35 Typical High $7,244.36 | Facility | None | $812.83 | $3,715.35 | $7,244.36 |
United Setting Professional Modifier None Typical Low $239.88 Median $2,691.53 Typical High $5,011.87 | Professional | None | $239.88 | $2,691.53 | $5,011.87 |
6 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 $141.25 Median $208.93 Typical High $1,621.81 | Professional | 52 · Reduced service | $141.25 | $208.93 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $645.65 | Professional | 53 · Discontinued | $56.23 | $83.18 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $2,398.83 | Professional | 54 · Surgery only | $208.93 | $309.03 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $489.78 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $323.59 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $323.59 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | 50 · Both sides | $4,265.80 | $4,265.80 | $4,265.80 |
Where Arizona sits
The same service costs 10.2 times more in Alaska than in Nebraska. 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· 16th of 51
$3,236
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.