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 $194.98 Median $199.53 Typical High $275.42 | Professional | None | $194.98 | $199.53 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
BCBS Arizona Setting Facility Modifier None Typical Low $181.97 Median $426.58 Typical High $1,122.02 | Facility | None | $181.97 | $426.58 | $1,122.02 |
BCBS Arizona Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $234.42 | Professional | None | $158.49 | $190.55 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $281.84 | Professional | None | $190.55 | $208.93 | $281.84 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $1,905.46 | Facility | None | $199.53 | $331.13 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $1,513.56 | Professional | None | $173.78 | $218.78 | $1,513.56 |
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 $173.78 Median $199.53 Typical High $281.84 | Professional | None | $173.78 | $199.53 | $281.84 |
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 $100.00 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $19.95 |
Where Arizona sits
The same service costs 3.0 times more in Wisconsin 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· 40th of 51
$219
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.