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 $48.98 Median $91.20 Typical High $138.04 | Professional | None | $48.98 | $91.20 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $97.72 | Professional | None | $69.18 | $69.18 | $97.72 |
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 $39.81 Median $85.11 Typical High $147.91 | Professional | None | $39.81 | $85.11 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $1,659.59 | Facility | None | $69.18 | $95.50 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $141.25 | Professional | None | $45.71 | $87.10 | $141.25 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $316.23 Typical High $1,584.89 | Facility | None | $70.79 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $588.84 Typical High $724.44 | Professional | None | $89.13 | $588.84 | $724.44 |
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 $48.98 Median $87.10 Typical High $144.54 | Professional | None | $48.98 | $87.10 | $144.54 |
6 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 $24.55 Median $44.67 Typical High $45.71 | Professional | 52 · Reduced service | $24.55 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $17.78 Typical High $18.20 | Professional | 53 · Discontinued | $9.77 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $66.07 Typical High $69.18 | Professional | 54 · Surgery only | $37.15 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $13.49 Typical High $13.80 | Professional | 55 · Aftercare only | $7.41 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $8.91 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.90 | $8.91 | $9.12 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 58 · Staged procedure | $102.33 | $102.33 | $102.33 |
Where Arizona sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 29th of 51
$110
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.