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 $194.98 Median $194.98 Typical High $208.93 | Professional | None | $194.98 | $194.98 | $208.93 |
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 $173.78 Median $173.78 Typical High $338.84 | Professional | None | $173.78 | $173.78 | $338.84 |
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 $186.21 Median $190.55 Typical High $316.23 | Professional | None | $186.21 | $190.55 | $316.23 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $812.83 Typical High $4,168.69 | Facility | None | $102.33 | $812.83 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $1,288.25 | Professional | None | $177.83 | $245.47 | $1,288.25 |
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 $177.83 Median $204.17 Typical High $346.74 | Professional | None | $177.83 | $204.17 | $346.74 |
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 $97.72 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | 53 · Discontinued | $39.81 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 54 · Surgery only | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $20.42 |
Where Arizona sits
The same service costs 4.3 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· 9th of 51
$437
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.