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 $70.79 Typical High $107.15 | Professional | None | $28.18 | $70.79 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | None | $79.43 | $95.50 | $95.50 |
BCBS Arizona Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $616.60 | Facility | None | $97.72 | $234.42 | $616.60 |
BCBS Arizona Setting Professional Modifier None Typical Low $21.88 Median $66.07 Typical High $112.20 | Professional | None | $21.88 | $66.07 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $66.07 Typical High $117.49 | Facility | None | $53.70 | $66.07 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $67.61 Typical High $109.65 | Professional | None | $26.92 | $67.61 | $109.65 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $316.23 Typical High $1,584.89 | Facility | None | $54.95 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $288.40 Typical High $660.69 | Professional | None | $77.62 | $288.40 | $660.69 |
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 $32.36 Median $69.18 Typical High $109.65 | Professional | None | $32.36 | $69.18 | $109.65 |
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 $34.67 Typical High $35.48 | Professional | 52 · Reduced service | $14.13 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $5.62 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $52.48 Typical High $53.70 | Professional | 54 · Surgery only | $20.89 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $10.47 Typical High $10.72 | Professional | 55 · Aftercare only | $4.17 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $6.92 Typical High $7.08 | Professional | 56 · Pre-op care only | $2.82 | $6.92 | $7.08 |
Where Arizona sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 28th of 51
$85.11
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.