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 $794.33 Median $794.33 Typical High $831.76 | Professional | None | $794.33 | $794.33 | $831.76 |
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 $691.83 Median $691.83 Typical High $1,348.96 | Professional | None | $691.83 | $691.83 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,398.83 Typical High $2,691.53 | Facility | None | $524.81 | $2,398.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,258.93 | Professional | None | $758.58 | $776.25 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $870.96 Typical High $4,365.16 | Facility | None | $102.33 | $870.96 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $5,248.07 | Professional | None | $707.95 | $1,000.00 | $5,248.07 |
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 $707.95 Median $812.83 Typical High $1,380.38 | Professional | None | $707.95 | $812.83 | $1,380.38 |
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 $398.11 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $588.84 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $81.28 |
Where Arizona sits
The same service costs 3.8 times more in Wisconsin 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· 32nd of 51
$1,023
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.