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 $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $41.69 Typical High $67.61 | Professional | None | $17.38 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $20.89 Typical High $33.88 | Professional | 52 · Reduced service | $8.71 | $20.89 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $8.32 Typical High $13.49 | Professional | 53 · Discontinued | $3.47 | $8.32 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $6.17 Typical High $10.00 | Professional | 55 · Aftercare only | $2.63 | $6.17 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $4.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $1.74 | $4.17 | $6.76 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $173.78 Typical High $302.00 | Facility | None | $43.65 | $173.78 | $302.00 |
BCBS Arizona Setting Professional Modifier None Typical Low $16.60 Median $51.29 Typical High $74.13 | Professional | None | $16.60 | $51.29 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Medica Setting Facility Modifier None Typical Low $19.05 Median $51.29 Typical High $104.71 | Facility | None | $19.05 | $51.29 | $104.71 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $302.00 Typical High $537.03 | Professional | None | $42.66 | $302.00 | $537.03 |
United Setting Professional Modifier None Typical Low $20.89 Median $37.15 Typical High $75.86 | Professional | None | $20.89 | $37.15 | $75.86 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 59 · Distinct service | $50.12 | $50.12 | $50.12 |
Where Arizona sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 20th of 51
$67.61
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.