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 $229.09 Median $912.01 Typical High $1,348.96 | Professional | None | $229.09 | $912.01 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $190.55 Median $812.83 Typical High $1,479.11 | Professional | None | $190.55 | $812.83 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $660.69 Typical High $1,621.81 | Professional | None | $218.78 | $660.69 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $1,230.27 Typical High $2,344.23 | Facility | None | $251.19 | $1,230.27 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $7,585.78 | Professional | None | $1,096.48 | $3,801.89 | $7,585.78 |
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 $213.80 Median $794.33 Typical High $1,548.82 | Professional | None | $213.80 | $794.33 | $1,548.82 |
7 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 $114.82 Median $323.59 Typical High $549.54 | Professional | 52 · Reduced service | $114.82 | $323.59 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $128.82 Typical High $218.78 | Professional | 53 · Discontinued | $45.71 | $128.82 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $489.78 Typical High $812.83 | Professional | 54 · Surgery only | $173.78 | $489.78 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $97.72 Typical High $162.18 | Professional | 55 · Aftercare only | $34.67 | $97.72 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $64.57 Typical High $109.65 | Professional | 56 · Pre-op care only | $22.91 | $64.57 | $109.65 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 59 · Distinct service | $165.96 | $165.96 | $165.96 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | XU · Unusual separate service | $109.65 | $109.65 | $109.65 |
Where Arizona sits
The same service costs 4.1 times more in Washington 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
$1,096
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.