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 $239.88 Median $977.24 Typical High $1,479.11 | Professional | None | $239.88 | $977.24 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $204.17 | Professional | None | $190.55 | $190.55 | $204.17 |
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 $208.93 Median $912.01 Typical High $1,659.59 | Professional | None | $208.93 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $741.31 Typical High $1,949.84 | Professional | None | $239.88 | $741.31 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $1,412.54 Typical High $2,344.23 | Facility | None | $281.84 | $1,412.54 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $4,570.88 Typical High $8,912.51 | Professional | None | $1,258.93 | $4,570.88 | $8,912.51 |
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 $229.09 Median $912.01 Typical High $1,862.09 | Professional | None | $229.09 | $912.01 | $1,862.09 |
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 $125.89 Median $354.81 Typical High $645.65 | Professional | 52 · Reduced service | $125.89 | $354.81 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $141.25 Typical High $257.04 | Professional | 53 · Discontinued | $51.29 | $141.25 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $537.03 Typical High $977.24 | Professional | 54 · Surgery only | $190.55 | $537.03 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $107.15 Typical High $194.98 | Professional | 55 · Aftercare only | $38.02 | $107.15 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $70.79 Typical High $128.82 | Professional | 56 · Pre-op care only | $25.70 | $70.79 | $128.82 |
Where Arizona sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 13th of 51
$1,288
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.