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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $134.90 | Professional | None | $47.86 | $72.44 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $39.81 Median $69.18 Typical High $128.82 | Professional | None | $39.81 | $69.18 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $134.90 | Professional | None | $50.12 | $77.62 | $134.90 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $323.59 Typical High $2,344.23 | Facility | None | $69.18 | $323.59 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $380.19 Typical High $660.69 | Professional | None | $81.28 | $380.19 | $660.69 |
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 $51.29 Median $77.62 Typical High $144.54 | Professional | None | $51.29 | $77.62 | $144.54 |
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 $23.99 Median $34.67 Typical High $36.31 | Professional | 52 · Reduced service | $23.99 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.80 Typical High $14.45 | Professional | 53 · Discontinued | $9.55 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $51.29 Typical High $54.95 | Professional | 54 · Surgery only | $36.31 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.47 Typical High $10.96 | Professional | 55 · Aftercare only | $7.24 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.92 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.79 | $6.92 | $7.24 |
Where Arizona sits
The same service costs 3.2 times more in Wisconsin 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· 32nd of 51
$93.33
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.