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 $5,495.41 Typical High $8,317.64 | Facility | None | $977.24 | $5,495.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | None | $102.33 | $102.33 | $147.91 |
BCBS Arizona Setting Facility Modifier None Typical Low $891.25 Median $2,089.30 Typical High $5,495.41 | Facility | None | $891.25 | $2,089.30 | $5,495.41 |
BCBS Arizona Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $281.84 | Professional | None | $128.82 | $138.04 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,995.26 Typical High $3,801.89 | Facility | None | $977.24 | $1,995.26 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $234.42 | Professional | None | $117.49 | $120.23 | $234.42 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $2,511.89 Typical High $9,549.93 | Facility | None | $181.97 | $2,511.89 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $1,071.52 | Professional | None | $123.03 | $181.97 | $1,071.52 |
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 $120.23 Median $138.04 Typical High $257.04 | Professional | None | $120.23 | $138.04 | $257.04 |
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 $51.29 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $20.42 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | 54 · Surgery only | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $11.48 |
Where Arizona sits
The same service costs 10.7 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· 7th of 51
$562
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.