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 $6,309.57 Typical High $10,715.19 | Facility | None | $977.24 | $6,309.57 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | None | $416.87 | $416.87 | $501.19 |
BCBS Setting Facility Modifier None Typical Low $190.55 Median $446.68 Typical High $1,174.90 | Facility | None | $190.55 | $446.68 | $1,174.90 |
BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $707.95 | Professional | None | $363.08 | $363.08 | $707.95 |
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 $398.11 Median $407.38 Typical High $794.33 | Professional | None | $398.11 | $407.38 | $794.33 |
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 $426.58 Median $691.83 Typical High $3,981.07 | Professional | None | $426.58 | $691.83 | $3,981.07 |
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 $389.05 Median $616.60 Typical High $758.58 | Professional | None | $389.05 | $616.60 | $758.58 |
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 $208.93 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $43.65 |
Where Arizona sits
The same service costs 3.7 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· 40th of 51
$631
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.