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 Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | None | $263.03 | $263.03 | $302.00 |
BCBS Arizona Setting Facility Modifier None Typical Low $199.53 Median $870.96 Typical High $1,318.26 | Facility | None | $199.53 | $870.96 | $1,318.26 |
BCBS Arizona Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $1,737.80 | Professional | None | $245.47 | $245.47 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $501.19 Typical High $537.03 | Facility | None | $354.81 | $501.19 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $229.09 Typical High $323.59 | Facility | None | $72.44 | $229.09 | $323.59 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | None | $263.03 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $309.03 | Professional | None | $288.40 | $309.03 | $309.03 |
4 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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Arizona sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 1st of 51
$407
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.