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 $87.10 Median $131.83 Typical High $208.93 | Professional | None | $87.10 | $131.83 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $104.71 Median $173.78 Typical High $331.13 | Professional | None | $104.71 | $173.78 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $1,659.59 | Facility | None | $81.28 | $112.20 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $218.78 | Professional | None | $89.13 | $134.90 | $218.78 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $309.03 Typical High $1,584.89 | Facility | None | $120.23 | $309.03 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $741.31 Typical High $1,122.02 | Professional | None | $128.82 | $741.31 | $1,122.02 |
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 $97.72 Median $131.83 Typical High $218.78 | Professional | None | $97.72 | $131.83 | $218.78 |
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 $43.65 Median $61.66 Typical High $66.07 | Professional | 52 · Reduced service | $43.65 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $25.12 Typical High $26.30 | Professional | 53 · Discontinued | $17.38 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $93.33 Typical High $100.00 | Professional | 54 · Surgery only | $66.07 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.62 Typical High $19.95 | Professional | 55 · Aftercare only | $13.18 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.30 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.71 | $12.30 | $13.18 |
Where Arizona sits
The same service costs 3.2 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· 35th of 51
$155
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.