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 $64.57 Median $275.42 Typical High $457.09 | Professional | None | $64.57 | $275.42 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
BCBS Arizona Setting Facility Modifier None Typical Low $85.11 Median $363.08 Typical High $537.03 | Facility | None | $85.11 | $363.08 | $537.03 |
BCBS Arizona Setting Professional Modifier None Typical Low $74.13 Median $354.81 Typical High $645.65 | Professional | None | $74.13 | $354.81 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $302.00 Typical High $588.84 | Professional | None | $72.44 | $302.00 | $588.84 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $3,630.78 Typical High $7,244.36 | Facility | None | $70.79 | $3,630.78 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $1,548.82 Typical High $3,090.30 | Professional | None | $371.54 | $1,548.82 | $3,090.30 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $6,309.57 Typical High $7,762.47 | Facility | None | $3,467.37 | $6,309.57 | $7,762.47 |
United Setting Professional Modifier None Typical Low $74.13 Median $309.03 Typical High $549.54 | Professional | None | $74.13 | $309.03 | $549.54 |
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 $32.36 Median $102.33 Typical High $186.21 | Professional | 52 · Reduced service | $32.36 | $102.33 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $40.74 Typical High $74.13 | Professional | 53 · Discontinued | $12.88 | $40.74 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $154.88 Typical High $281.84 | Professional | 54 · Surgery only | $47.86 | $154.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $30.90 Typical High $56.23 | Professional | 55 · Aftercare only | $9.55 | $30.90 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $20.42 Typical High $37.15 | Professional | 56 · Pre-op care only | $6.46 | $20.42 | $37.15 |
Where Arizona sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 20th of 51
$389
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.