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 $186.21 Median $309.03 Typical High $346.74 | Professional | None | $186.21 | $309.03 | $346.74 |
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 $147.91 Median $275.42 Typical High $489.78 | Professional | None | $147.91 | $275.42 | $489.78 |
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 $173.78 Median $295.12 Typical High $457.09 | Professional | None | $173.78 | $295.12 | $457.09 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $912.01 Typical High $3,388.44 | Facility | None | $323.59 | $912.01 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,584.89 Typical High $2,630.27 | Professional | None | $275.42 | $1,584.89 | $2,630.27 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $4,897.79 | Facility | None | $501.19 | $1,174.90 | $4,897.79 |
United Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $467.74 | Professional | None | $186.21 | $275.42 | $467.74 |
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 $91.20 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $91.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $61.66 Typical High $63.10 | Professional | 53 · Discontinued | $37.15 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $229.09 Typical High $234.42 | Professional | 54 · Surgery only | $138.04 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $45.71 Typical High $46.77 | Professional | 55 · Aftercare only | $27.54 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.62 | $30.90 | $30.90 |
Where Arizona sits
The same service costs 3.0 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· 39th of 51
$347
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.