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 $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $60.26 Median $64.57 Typical High $131.83 | Professional | None | $60.26 | $64.57 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $144.54 | Professional | None | $74.13 | $77.62 | $144.54 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $812.83 Typical High $4,073.80 | Facility | None | $100.00 | $812.83 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $616.60 | Professional | None | $77.62 | $112.20 | $616.60 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $154.88 | Professional | None | $74.13 | $91.20 | $154.88 |
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 $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 54 · Surgery only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where Arizona sits
The same service costs 6.5 times more in Tennessee 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
$135
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.