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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,479.11 Typical High $2,570.40 | Professional | None | $346.74 | $1,479.11 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $331.13 | Professional | None | $147.91 | $218.78 | $331.13 |
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 $331.13 Median $1,737.80 Typical High $3,162.28 | Professional | None | $331.13 | $1,737.80 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,348.96 Typical High $2,951.21 | Professional | None | $371.54 | $1,348.96 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $6,606.93 Typical High $10,715.19 | Facility | None | $436.52 | $6,606.93 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $7,585.78 Typical High $14,454.40 | Professional | None | $1,819.70 | $7,585.78 | $14,454.40 |
United Setting Facility Modifier None Typical Low $5,623.41 Median $8,912.51 Typical High $10,964.78 | Facility | None | $5,623.41 | $8,912.51 | $10,964.78 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,513.56 Typical High $2,754.23 | Professional | None | $338.84 | $1,513.56 | $2,754.23 |
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 $199.53 Median $524.81 Typical High $1,071.52 | Professional | 52 · Reduced service | $199.53 | $524.81 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $208.93 Typical High $426.58 | Professional | 53 · Discontinued | $79.43 | $208.93 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $794.33 Typical High $1,621.81 | Professional | 54 · Surgery only | $302.00 | $794.33 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $158.49 Typical High $323.59 | Professional | 55 · Aftercare only | $60.26 | $158.49 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $104.71 Typical High $213.80 | Professional | 56 · Pre-op care only | $39.81 | $104.71 | $213.80 |
Where Arizona sits
The same service costs 6.2 times more in Washington 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· 14th of 51
$1,995
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.