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 $162.18 Median $208.93 Typical High $645.65 | Facility | None | $162.18 | $208.93 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $302.00 | Professional | None | $162.18 | $208.93 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $354.81 | Professional | None | $138.04 | $165.96 | $354.81 |
BCBS Arizona Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $302.00 | Professional | None | $177.83 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $4,466.84 | Facility | None | $2,691.53 | $3,311.31 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $338.84 | Professional | None | $169.82 | $218.78 | $338.84 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $229.09 Typical High $389.05 | Facility | None | $177.83 | $229.09 | $389.05 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $1,348.96 Typical High $1,737.80 | Professional | None | $245.47 | $1,348.96 | $1,737.80 |
United Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $316.23 | Professional | None | $194.98 | $239.88 | $316.23 |
7 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 $81.28 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.22 | $20.89 | $20.89 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 24 · Unrelated visit after surgery | $147.91 | $177.83 | $177.83 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $154.88 Median $204.17 Typical High $295.12 | Professional | 25 · Same-day visit | $154.88 | $204.17 | $295.12 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | FS · Shared visit | $154.88 | $154.88 | $154.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $223.87 Median $281.84 Typical High $346.74 | Professional | GC · Resident with teaching physician | $223.87 | $281.84 | $346.74 |
Where Arizona sits
The same service costs 2.8 times more in Minnesota than in New Jersey. 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
$229
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.