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 $39.81 Median $64.57 Typical High $102.33 | Professional | None | $39.81 | $64.57 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $69.18 | Professional | None | $47.86 | $54.95 | $69.18 |
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 $46.77 Median $81.28 Typical High $154.88 | Professional | None | $46.77 | $81.28 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $75.86 | Facility | None | $34.67 | $45.71 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $104.71 | Professional | None | $40.74 | $66.07 | $104.71 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $316.23 Typical High $1,584.89 | Facility | None | $57.54 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $338.84 Typical High $549.54 | Professional | None | $66.07 | $338.84 | $549.54 |
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 $43.65 Median $66.07 Typical High $109.65 | Professional | None | $43.65 | $66.07 | $109.65 |
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 $19.95 Median $29.51 Typical High $32.36 | Professional | 52 · Reduced service | $19.95 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $11.75 Typical High $12.88 | Professional | 53 · Discontinued | $7.94 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $44.67 Typical High $48.98 | Professional | 54 · Surgery only | $30.20 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.91 Typical High $9.77 | Professional | 55 · Aftercare only | $6.03 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.98 | $5.89 | $6.46 |
Where Arizona sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 31st of 51
$79.43
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.