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 $288.40 Median $933.25 Typical High $1,380.38 | Professional | None | $288.40 | $933.25 | $1,380.38 |
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 $245.47 Median $831.76 Typical High $1,513.56 | Professional | None | $245.47 | $831.76 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $794.33 Typical High $1,737.80 | Professional | None | $269.15 | $794.33 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $1,288.25 Typical High $2,344.23 | Facility | None | $323.59 | $1,288.25 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $3,981.07 Typical High $7,762.47 | Professional | None | $1,174.90 | $3,981.07 | $7,762.47 |
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 $257.04 Median $870.96 Typical High $1,621.81 | Professional | None | $257.04 | $870.96 | $1,621.81 |
6 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 $147.91 Median $407.38 Typical High $562.34 | Professional | 52 · Reduced service | $147.91 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $162.18 Typical High $223.87 | Professional | 53 · Discontinued | $58.88 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $602.56 Typical High $851.14 | Professional | 54 · Surgery only | $218.78 | $602.56 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $120.23 Typical High $169.82 | Professional | 55 · Aftercare only | $43.65 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $81.28 Typical High $112.20 | Professional | 56 · Pre-op care only | $29.51 | $81.28 | $112.20 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | XU · Unusual separate service | $512.86 | $512.86 | $512.86 |
Where Arizona sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 16th of 51
$1,122
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.