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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $478.63 Typical High $724.44 | Professional | None | $151.36 | $478.63 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $389.05 | Professional | None | $120.23 | $120.23 | $389.05 |
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 $125.89 Median $426.58 Typical High $794.33 | Professional | None | $125.89 | $426.58 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $426.58 Typical High $933.25 | Professional | None | $141.25 | $426.58 | $933.25 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $954.99 Typical High $2,344.23 | Facility | None | $165.96 | $954.99 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $2,187.76 Typical High $4,265.80 | Professional | None | $602.56 | $2,187.76 | $4,265.80 |
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 $138.04 Median $457.09 Typical High $851.14 | Professional | None | $138.04 | $457.09 | $851.14 |
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 $74.13 Median $208.93 Typical High $309.03 | Professional | 52 · Reduced service | $74.13 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $83.18 Typical High $123.03 | Professional | 53 · Discontinued | $30.20 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $309.03 Typical High $457.09 | Professional | 54 · Surgery only | $112.20 | $309.03 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $61.66 Typical High $93.33 | Professional | 55 · Aftercare only | $22.39 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $41.69 Typical High $61.66 | Professional | 56 · Pre-op care only | $15.14 | $41.69 | $61.66 |
Where Arizona sits
The same service costs 3.8 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· 11th of 51
$617
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.