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 $107.15 Median $107.15 Typical High $1,288.25 | Professional | None | $107.15 | $107.15 | $1,288.25 |
BCBS Arizona Setting Facility Modifier None Typical Low $436.52 Median $1,905.46 Typical High $2,818.38 | Facility | None | $436.52 | $1,905.46 | $2,818.38 |
BCBS Arizona Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $724.44 | Professional | None | $102.33 | $102.33 | $724.44 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $2,089.30 Typical High $5,128.61 | Facility | None | $117.49 | $2,089.30 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $229.09 | Professional | None | $112.20 | $138.04 | $229.09 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,235.94 Typical High $5,495.41 | Facility | None | $1,479.11 | $3,235.94 | $5,495.41 |
United Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $245.47 | Professional | None | $107.15 | $138.04 | $245.47 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 54 · Surgery only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where Arizona sits
The same service costs 37.2 times more in Oklahoma 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· 9th of 51
$1,698
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.