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 $28.18 Median $91.20 Typical High $112.20 | Professional | None | $28.18 | $91.20 | $112.20 |
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 $33.88 Median $114.82 Typical High $204.17 | Professional | None | $33.88 | $114.82 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $186.21 | Facility | None | $66.07 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $83.18 Typical High $131.83 | Professional | None | $28.18 | $83.18 | $131.83 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $331.13 Typical High $2,187.76 | Facility | None | $89.13 | $331.13 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $741.31 Typical High $812.83 | Professional | None | $93.33 | $741.31 | $812.83 |
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 $28.84 Median $77.62 Typical High $147.91 | Professional | None | $28.84 | $77.62 | $147.91 |
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 $14.13 Median $29.51 Typical High $45.71 | Professional | 52 · Reduced service | $14.13 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $11.75 Typical High $18.62 | Professional | 53 · Discontinued | $5.62 | $11.75 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $44.67 Typical High $69.18 | Professional | 54 · Surgery only | $20.89 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $8.91 Typical High $13.80 | Professional | 55 · Aftercare only | $4.17 | $8.91 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $5.89 Typical High $9.12 | Professional | 56 · Pre-op care only | $2.82 | $5.89 | $9.12 |
Where Arizona sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 18th of 51
$115
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.