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 $107.15 Median $154.88 Typical High $239.88 | Professional | None | $107.15 | $154.88 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $125.89 Median $208.93 Typical High $407.38 | Professional | None | $125.89 | $208.93 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $134.90 Typical High $1,659.59 | Facility | None | $97.72 | $134.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $257.04 | Professional | None | $107.15 | $158.49 | $257.04 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $549.54 Typical High $2,238.72 | Facility | None | $154.88 | $549.54 | $2,238.72 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $891.25 Typical High $1,318.26 | Professional | None | $151.36 | $891.25 | $1,318.26 |
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 $114.82 Median $154.88 Typical High $263.03 | Professional | None | $114.82 | $154.88 | $263.03 |
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 $53.70 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $53.70 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $109.65 Typical High $117.49 | Professional | 54 · Surgery only | $79.43 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $15.85 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.72 | $14.79 | $15.49 |
Where Arizona sits
The same service costs 3.7 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· 28th of 51
$200
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.