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 $13.49 Median $14.45 Typical High $30.20 | Professional | None | $13.49 | $14.45 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $21.38 | Professional | None | $14.13 | $16.60 | $21.38 |
BCBS Arizona Setting Facility Modifier None Typical Low $12.02 Median $28.18 Typical High $74.13 | Facility | None | $12.02 | $28.18 | $74.13 |
BCBS Arizona Setting Professional Modifier None Typical Low $15.14 Median $16.22 Typical High $33.11 | Professional | None | $15.14 | $16.22 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $1,047.13 | Facility | None | $66.07 | $66.07 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $15.14 Typical High $26.30 | Professional | None | $13.18 | $15.14 | $26.30 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $316.23 Typical High $1,905.46 | Facility | None | $54.95 | $316.23 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $12.30 Median $16.98 Typical High $117.49 | Professional | None | $12.30 | $16.98 | $117.49 |
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 $11.75 Median $14.13 Typical High $26.92 | Professional | None | $11.75 | $14.13 | $26.92 |
7 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 $7.24 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 54 · Surgery only | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $19.95 Median $20.89 Typical High $25.70 | Professional | 50 · Both sides | $19.95 | $20.89 | $25.70 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $13.18 Median $15.14 Typical High $23.44 | Professional | 59 · Distinct service | $13.18 | $15.14 | $23.44 |
Where Arizona sits
The same service costs 7.4 times more in Kansas 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· 46th of 51
$18.62
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.