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 $54.95 Median $87.10 Typical High $162.18 | Professional | None | $54.95 | $87.10 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $120.23 | Professional | None | $85.11 | $95.50 | $120.23 |
BCBS Arizona Setting Facility Modifier None Typical Low $75.86 Median $177.83 Typical High $467.74 | Facility | None | $75.86 | $177.83 | $467.74 |
BCBS Arizona Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $208.93 | Professional | None | $64.57 | $114.82 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $107.15 | Facility | None | $50.12 | $63.10 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $91.20 Typical High $151.36 | Professional | None | $56.23 | $91.20 | $151.36 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $316.23 Typical High $2,344.23 | Facility | None | $95.50 | $316.23 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $467.74 Typical High $758.58 | Professional | None | $95.50 | $467.74 | $758.58 |
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 $67.61 Median $95.50 Typical High $151.36 | Professional | None | $67.61 | $95.50 | $151.36 |
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 $27.54 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $27.54 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $10.96 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $66.07 Typical High $66.07 | Professional | 54 · Surgery only | $41.69 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $8.32 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.50 | $8.71 | $8.71 |
Where Arizona sits
The same service costs 3.0 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· 38th of 51
$107
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.