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 $338.84 Median $1,548.82 Typical High $2,454.71 | Professional | None | $338.84 | $1,548.82 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $309.03 Median $1,513.56 Typical High $2,754.23 | Professional | None | $309.03 | $1,513.56 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $1,071.52 Typical High $2,951.21 | Professional | None | $323.59 | $1,071.52 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,905.46 Typical High $2,630.27 | Facility | None | $398.11 | $1,905.46 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $6,760.83 Typical High $13,182.57 | Professional | None | $1,949.84 | $6,760.83 | $13,182.57 |
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 $309.03 Median $1,445.44 Typical High $2,691.53 | Professional | None | $309.03 | $1,445.44 | $2,691.53 |
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 $181.97 Median $489.78 Typical High $977.24 | Professional | 52 · Reduced service | $181.97 | $489.78 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $194.98 Typical High $389.05 | Professional | 53 · Discontinued | $72.44 | $194.98 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $724.44 Typical High $1,479.11 | Professional | 54 · Surgery only | $275.42 | $724.44 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $144.54 Typical High $295.12 | Professional | 55 · Aftercare only | $54.95 | $144.54 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $97.72 Typical High $194.98 | Professional | 56 · Pre-op care only | $36.31 | $97.72 | $194.98 |
Where Arizona sits
The same service costs 5.5 times more in Washington than in Kentucky. 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
$1,950
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.