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 $162.18 Median $416.87 Typical High $575.44 | Professional | None | $162.18 | $416.87 | $575.44 |
BCBS Arizona Setting Facility Modifier None Typical Low $85.11 Median $363.08 Typical High $537.03 | Facility | None | $85.11 | $363.08 | $537.03 |
BCBS Arizona Setting Professional Modifier None Typical Low $134.90 Median $426.58 Typical High $724.44 | Professional | None | $134.90 | $426.58 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $436.52 Typical High $794.33 | Professional | None | $154.88 | $436.52 | $794.33 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $954.99 Typical High $2,344.23 | Facility | None | $181.97 | $954.99 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,890.45 | Professional | None | $512.86 | $2,041.74 | $3,890.45 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,949.84 Typical High $2,454.71 | Facility | None | $812.83 | $1,949.84 | $2,454.71 |
United Setting Professional Modifier None Typical Low $144.54 Median $398.11 Typical High $741.31 | Professional | None | $144.54 | $398.11 | $741.31 |
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 $81.28 Median $204.17 Typical High $288.40 | Professional | 52 · Reduced service | $81.28 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $83.18 Typical High $114.82 | Professional | 53 · Discontinued | $32.36 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $309.03 Typical High $436.52 | Professional | 54 · Surgery only | $123.03 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $24.55 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $41.69 Typical High $57.54 | Professional | 56 · Pre-op care only | $16.22 | $41.69 | $57.54 |
Where Arizona sits
The same service costs 3.5 times more in Wisconsin than in Nebraska. 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· 12th of 51
$550
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.