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 $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $158.49 | Professional | None | $83.18 | $134.90 | $158.49 |
BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $269.15 | Professional | None | $100.00 | $223.87 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,659.59 Typical High $2,951.21 | Facility | None | $724.44 | $1,659.59 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $199.53 | Professional | None | $91.20 | $141.25 | $199.53 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $1,445.44 Typical High $7,943.28 | Facility | None | $169.82 | $1,445.44 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $870.96 Typical High $1,318.26 | Professional | None | $134.90 | $870.96 | $1,318.26 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $177.83 | Professional | None | $85.11 | $131.83 | $177.83 |
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 $41.69 Median $66.07 Typical High $79.43 | Professional | 52 · Reduced service | $41.69 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $31.62 | Professional | 53 · Discontinued | $16.60 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $63.10 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $12.59 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.18 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.32 | $13.18 | $15.85 |
Where Arizona sits
The same service costs 3.6 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· 37th of 51
$158
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.