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 (both parts) Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | None (both parts) | $75.86 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $38.02 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $17.78 | Professional | 53 · Discontinued | $15.14 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $8.91 |
BCBS Arizona Setting Facility Modifier None Typical Low $93.33 Median $407.38 Typical High $602.56 | Facility | None | $93.33 | $407.38 | $602.56 |
BCBS Arizona Setting Professional Modifier None (both parts) Typical Low $57.54 Median $66.07 Typical High $114.82 | Professional | None (both parts) | $57.54 | $66.07 | $114.82 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $83.18 Typical High $165.96 | Professional | None (both parts) | $79.43 | $83.18 | $165.96 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $194.98 | Facility | None | $75.86 | $83.18 | $194.98 |
Medica Setting Professional Modifier None (both parts) Typical Low $81.28 Median $144.54 Typical High $537.03 | Professional | None (both parts) | $81.28 | $144.54 | $537.03 |
United Setting Professional Modifier None (both parts) Typical Low $75.86 Median $89.13 Typical High $151.36 | Professional | None (both parts) | $75.86 | $89.13 | $151.36 |
3 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 TC · Technical part Typical Low $75.86 Median $85.11 Typical High $107.15 | Professional | TC · Technical part | $75.86 | $85.11 | $107.15 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $77.62 Median $100.00 Typical High $199.53 | Professional | TC · Technical part | $77.62 | $100.00 | $199.53 |
Medica Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | TC · Technical part | $467.74 | $467.74 | $467.74 |
Where Arizona sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$83.18
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.