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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $134.90 | Professional | None | $79.43 | $79.43 | $134.90 |
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 $100.00 Median $107.15 Typical High $223.87 | Professional | None | $100.00 | $107.15 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $3,548.13 | Facility | None | $758.58 | $1,862.09 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $177.83 | Professional | None | $91.20 | $93.33 | $177.83 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $1,778.28 Typical High $9,549.93 | Facility | None | $123.03 | $1,778.28 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $1,513.56 | Professional | None | $95.50 | $141.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $199.53 | Professional | None | $93.33 | $107.15 | $199.53 |
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 $39.81 Median $39.81 Typical High $44.67 | Professional | 52 · Reduced service | $39.81 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 53 · Discontinued | $15.85 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.91 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | GC · Resident with teaching physician | $131.83 | $131.83 | $131.83 |
Where Arizona sits
The same service costs 7.9 times more in Kansas 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· 12th of 51
$204
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.