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 $295.12 Median $309.03 Typical High $316.23 | Professional | None | $295.12 | $309.03 | $316.23 |
BCBS Arizona Setting Facility Modifier None Typical Low $831.76 Median $1,949.84 Typical High $5,128.61 | Facility | None | $831.76 | $1,949.84 | $5,128.61 |
BCBS Arizona Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $524.81 | Professional | None | $263.03 | $263.03 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $2,691.53 | Facility | None | $524.81 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $446.68 | Professional | None | $275.42 | $302.00 | $446.68 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $812.83 Typical High $4,073.80 | Facility | None | $104.71 | $812.83 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $14,791.08 | Professional | None | $269.15 | $380.19 | $14,791.08 |
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 $257.04 Median $295.12 Typical High $524.81 | Professional | None | $257.04 | $295.12 | $524.81 |
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 $151.36 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 53 · Discontinued | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | 54 · Surgery only | $229.09 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $31.62 |
Where Arizona sits
The same service costs 3.9 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· 16th of 51
$525
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.