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 $44.67 Median $100.00 Typical High $125.89 | Professional | None | $44.67 | $100.00 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $128.82 | Professional | None | $20.89 | $20.89 | $128.82 |
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 $53.70 Median $131.83 Typical High $204.17 | Professional | None | $53.70 | $131.83 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $165.96 Typical High $1,659.59 | Facility | None | $120.23 | $165.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $89.13 Typical High $138.04 | Professional | None | $44.67 | $89.13 | $138.04 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $575.44 Typical High $1,862.09 | Facility | None | $117.49 | $575.44 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $489.78 Typical High $954.99 | Professional | None | $100.00 | $489.78 | $954.99 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $125.89 | Professional | None | $42.66 | $87.10 | $125.89 |
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 $22.39 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $22.39 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $8.91 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $33.88 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $6.76 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.47 | $9.77 | $11.75 |
Where Arizona sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 25th of 51
$117
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.