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 Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | None | $61.66 | $61.66 | $66.07 |
BCBS Arizona Setting Facility Modifier None Typical Low $85.11 Median $199.53 Typical High $524.81 | Facility | None | $85.11 | $199.53 | $524.81 |
BCBS Arizona Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $138.04 | Professional | None | $63.10 | $67.61 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $323.59 | $1,659.59 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $125.89 | Professional | None | $70.79 | $75.86 | $125.89 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $338.84 Typical High $1,905.46 | Facility | None | $87.10 | $338.84 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $660.69 | Professional | None | $67.61 | $93.33 | $660.69 |
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 $64.57 Median $75.86 Typical High $138.04 | Professional | None | $64.57 | $75.86 | $138.04 |
4 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 $30.90 Median $30.90 Typical High $33.11 | Professional | 52 · Reduced service | $30.90 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $13.18 | Professional | 53 · Discontinued | $12.30 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.61 |
Where Arizona sits
The same service costs 4.5 times more in Wisconsin 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· 30th of 51
$105
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.