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 $851.14 Median $3,715.35 Typical High $5,623.41 | Facility | None | $851.14 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $64.57 Typical High $104.71 | Professional | None | $36.31 | $64.57 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
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 $57.54 Typical High $74.13 | Professional | None | $27.54 | $57.54 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $75.86 Typical High $1,659.59 | Facility | None | $54.95 | $75.86 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $75.86 Typical High $109.65 | Professional | None | $41.69 | $75.86 | $109.65 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $602.56 Typical High $2,951.21 | Facility | None | $70.79 | $602.56 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $724.44 Typical High $1,348.96 | Professional | None | $72.44 | $724.44 | $1,348.96 |
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 $40.74 Median $70.79 Typical High $107.15 | Professional | None | $40.74 | $70.79 | $107.15 |
6 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 $18.20 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $18.20 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $7.24 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $48.98 Typical High $48.98 | Professional | 54 · Surgery only | $26.92 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $5.50 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.63 | $6.46 | $6.46 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 50 · Both sides | $117.49 | $117.49 | $117.49 |
Where Arizona sits
The same service costs 3.5 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· 40th of 51
$75.86
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.