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 $158.49 Median $158.49 Typical High $190.55 | Professional | None | $158.49 | $158.49 | $190.55 |
BCBS Arizona Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Facility | None | $416.87 | $977.24 | $2,570.40 |
BCBS Arizona Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $354.81 | Professional | None | $158.49 | $173.78 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,548.82 | $2,884.03 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $323.59 | Professional | None | $194.98 | $199.53 | $323.59 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $3,090.30 Typical High $8,128.31 | Facility | None | $229.09 | $3,090.30 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $43,651.58 | Professional | None | $177.83 | $257.04 | $43,651.58 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $8,317.64 | Facility | None | $977.24 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $371.54 | Professional | None | $177.83 | $208.93 | $371.54 |
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 $79.43 Median $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $79.43 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | 53 · Discontinued | $31.62 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 54 · Surgery only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $17.38 |
Where Arizona sits
The same service costs 10.2 times more in Oklahoma 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· 12th of 51
$417
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.