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 $72.44 Median $223.87 Typical High $234.42 | Facility | None | $72.44 | $223.87 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $128.82 | Professional | None | $45.71 | $89.13 | $128.82 |
BCBS Arizona Setting Facility Modifier None Typical Low $45.71 Median $194.98 Typical High $295.12 | Facility | None | $45.71 | $194.98 | $295.12 |
BCBS Arizona Setting Professional Modifier None Typical Low $35.48 Median $93.33 Typical High $141.25 | Professional | None | $35.48 | $93.33 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $109.65 Typical High $154.88 | Professional | None | $41.69 | $109.65 | $154.88 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $128.82 Typical High $186.21 | Facility | None | $45.71 | $128.82 | $186.21 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $478.63 Typical High $851.14 | Professional | None | $117.49 | $478.63 | $851.14 |
United Setting Professional Modifier None Typical Low $39.81 Median $97.72 Typical High $162.18 | Professional | None | $39.81 | $97.72 | $162.18 |
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 $22.91 Median $40.74 Typical High $64.57 | Professional | 52 · Reduced service | $22.91 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.60 Typical High $26.30 | Professional | 53 · Discontinued | $9.12 | $16.60 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $12.30 Typical High $19.50 | Professional | 55 · Aftercare only | $6.92 | $12.30 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.13 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.57 | $8.13 | $12.88 |
Where Arizona sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 22nd of 51
$123
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.