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 $57.54 Median $89.13 Typical High $134.90 | Professional | None | $57.54 | $89.13 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $125.89 | Professional | None | $93.33 | $125.89 | $125.89 |
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 $67.61 Median $123.03 Typical High $223.87 | Professional | None | $67.61 | $123.03 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $83.18 Typical High $1,659.59 | Facility | None | $58.88 | $83.18 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $144.54 | Professional | None | $57.54 | $91.20 | $144.54 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,862.09 | Facility | None | $89.13 | $616.60 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $758.58 Typical High $776.25 | Professional | None | $85.11 | $758.58 | $776.25 |
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 $61.66 Median $85.11 Typical High $141.25 | Professional | None | $61.66 | $85.11 | $141.25 |
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 $28.84 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $28.84 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $11.48 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $61.66 Typical High $67.61 | Professional | 54 · Surgery only | $42.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $8.51 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $8.91 |
Where Arizona sits
The same service costs 3.6 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
$112
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.