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 $75.86 Median $173.78 Typical High $234.42 | Professional | None | $75.86 | $173.78 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | None | $75.86 | $75.86 | $89.13 |
BCBS Arizona Setting Facility Modifier None Typical Low $109.65 Median $467.74 Typical High $707.95 | Facility | None | $109.65 | $467.74 | $707.95 |
BCBS Arizona Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $204.17 | Professional | None | $63.10 | $85.11 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $275.42 | Professional | None | $72.44 | $158.49 | $275.42 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $933.25 Typical High $2,344.23 | Facility | None | $83.18 | $933.25 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $660.69 Typical High $1,258.93 | Professional | None | $194.98 | $660.69 | $1,258.93 |
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 $69.18 Median $165.96 Typical High $269.15 | Professional | None | $69.18 | $165.96 | $269.15 |
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 $38.02 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $38.02 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $15.14 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $57.54 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $11.48 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $7.59 | $16.22 | $18.62 |
Where Arizona sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 24th of 51
$186
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.