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 $38.02 Median $69.18 Typical High $112.20 | Professional | None | $38.02 | $69.18 | $112.20 |
BCBS Arizona Setting Facility Modifier None Typical Low $194.98 Median $457.09 Typical High $1,202.26 | Facility | None | $194.98 | $457.09 | $1,202.26 |
BCBS Arizona Setting Professional Modifier None Typical Low $27.54 Median $53.70 Typical High $70.79 | Professional | None | $27.54 | $53.70 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $66.07 Typical High $1,659.59 | Facility | None | $46.77 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $81.28 Typical High $158.49 | Professional | None | $43.65 | $81.28 | $158.49 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $575.44 Typical High $1,862.09 | Facility | None | $75.86 | $575.44 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $1,023.29 | Professional | None | $69.18 | $147.91 | $1,023.29 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $41.69 Median $81.28 Typical High $147.91 | Professional | None | $41.69 | $81.28 | $147.91 |
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 $19.05 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $19.05 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $7.59 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $51.29 Typical High $51.29 | Professional | 54 · Surgery only | $28.84 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $5.75 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.80 | $6.92 | $6.92 |
Where Arizona sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 41st of 51
$81.28
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.