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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | None | $42.66 | $42.66 | $45.71 |
BCBS Arizona Setting Facility Modifier None Typical Low $11.48 Median $27.54 Typical High $72.44 | Facility | None | $11.48 | $27.54 | $72.44 |
BCBS Arizona Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | None | $33.88 | $33.88 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $63.10 | Professional | None | $35.48 | $40.74 | $63.10 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $354.81 Typical High $1,862.09 | Facility | None | $61.66 | $354.81 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $912.01 | Professional | None | $35.48 | $53.70 | $912.01 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $69.18 | Professional | None | $34.67 | $41.69 | $69.18 |
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 $21.38 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | 54 · Surgery only | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.37 |
Where Arizona sits
The same service costs 9.3 times more in Tennessee than in New York. 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· 40th of 51
$56.23
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.