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 $45.71 Median $97.72 Typical High $120.23 | Professional | None | $45.71 | $97.72 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
BCBS Arizona Setting Facility Modifier None Typical Low $131.83 Median $309.03 Typical High $812.83 | Facility | None | $131.83 | $309.03 | $812.83 |
BCBS Arizona Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $109.65 | Professional | None | $33.88 | $87.10 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $1,659.59 | Facility | None | $91.20 | $128.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $141.25 | Professional | None | $50.12 | $93.33 | $141.25 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $331.13 Typical High $1,584.89 | Facility | None | $97.72 | $331.13 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $812.83 Typical High $1,023.29 | Professional | None | $97.72 | $812.83 | $1,023.29 |
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 $47.86 Median $91.20 Typical High $128.82 | Professional | None | $47.86 | $91.20 | $128.82 |
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 $22.91 Median $43.65 Typical High $48.98 | Professional | 52 · Reduced service | $22.91 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $9.12 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $64.57 Typical High $72.44 | Professional | 54 · Surgery only | $33.88 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.88 Typical High $14.79 | Professional | 55 · Aftercare only | $6.76 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.57 | $8.71 | $9.77 |
Where Arizona sits
The same service costs 3.4 times more in Alaska 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· 42nd of 51
$100
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.