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 $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $457.09 | Professional | None | $269.15 | $269.15 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $707.95 | Professional | None | $323.59 | $346.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $4,786.30 | Facility | None | $758.58 | $2,630.27 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $588.84 | Professional | None | $275.42 | $302.00 | $588.84 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $2,754.23 Typical High $12,589.25 | Facility | None | $501.19 | $2,754.23 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $4,786.30 | Professional | None | $309.03 | $457.09 | $4,786.30 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,244.36 | Facility | None | $812.83 | $2,951.21 | $7,244.36 |
United Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $616.60 | Professional | None | $302.00 | $380.19 | $616.60 |
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 $134.90 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 53 · Discontinued | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $213.80 | Professional | 54 · Surgery only | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $28.18 |
Where Arizona sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 17th of 51
$631
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.