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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $158.49 | Professional | None | $87.10 | $123.03 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $72.44 Median $120.23 Typical High $229.09 | Professional | None | $72.44 | $120.23 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $151.36 | Facility | None | $66.07 | $83.18 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $186.21 | Professional | None | $74.13 | $107.15 | $186.21 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $1,862.09 | Facility | None | $123.03 | $549.54 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $630.96 Typical High $891.25 | Professional | None | $112.20 | $630.96 | $891.25 |
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 $79.43 Median $114.82 Typical High $181.97 | Professional | None | $79.43 | $114.82 | $181.97 |
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 $42.66 Median $57.54 Typical High $61.66 | Professional | 52 · Reduced service | $42.66 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $87.10 Typical High $91.20 | Professional | 54 · Surgery only | $64.57 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $12.88 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $11.75 | $12.30 |
Where Arizona sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 34th of 51
$132
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.