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 $154.88 Median $338.84 Typical High $338.84 | Professional | None | $154.88 | $338.84 | $338.84 |
BCBS Arizona 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 Arizona Setting Professional Modifier None Typical Low $123.03 Median $309.03 Typical High $537.03 | Professional | None | $123.03 | $309.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $436.52 Typical High $2,187.76 | Facility | None | $295.12 | $436.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $549.54 | Professional | None | $144.54 | $338.84 | $549.54 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $616.60 Typical High $2,818.38 | Facility | None | $295.12 | $616.60 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $1,445.44 Typical High $2,818.38 | Professional | None | $371.54 | $1,445.44 | $2,818.38 |
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 $154.88 Median $338.84 Typical High $562.34 | Professional | None | $154.88 | $338.84 | $562.34 |
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 $77.62 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $77.62 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $30.90 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $229.09 Typical High $251.19 | Professional | 54 · Surgery only | $117.49 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $23.44 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.49 | $30.90 | $33.88 |
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· 27th of 51
$407
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.