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 $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $112.20 | Professional | None | $30.90 | $69.18 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $74.13 Typical High $100.00 | Professional | None | $26.30 | $74.13 | $100.00 |
BCBS Arizona Setting Facility Modifier None Typical Low $79.43 Median $190.55 Typical High $501.19 | Facility | None | $79.43 | $190.55 | $501.19 |
BCBS Arizona Setting Professional Modifier None Typical Low $23.99 Median $58.88 Typical High $89.13 | Professional | None | $23.99 | $58.88 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $47.86 Typical High $91.20 | Professional | None | $29.51 | $47.86 | $91.20 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $302.00 Typical High $1,905.46 | Facility | None | $79.43 | $302.00 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $380.19 Typical High $645.65 | Professional | None | $58.88 | $380.19 | $645.65 |
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 $28.18 Median $50.12 Typical High $100.00 | Professional | None | $28.18 | $50.12 | $100.00 |
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 54 · Surgery only Typical Low $23.99 Median $44.67 Typical High $67.61 | Professional | 54 · Surgery only | $23.99 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $8.91 Typical High $13.49 | Professional | 55 · Aftercare only | $4.79 | $8.91 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $5.89 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.24 | $5.89 | $9.12 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 58 · Staged procedure | $89.13 | $89.13 | $89.13 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 59 · Distinct service | $83.18 | $83.18 | $83.18 |
Where Arizona sits
The same service costs 2.8 times more in Alaska 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· 16th of 51
$89.13
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.