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 $234.42 Median $309.03 Typical High $354.81 | Facility | None | $234.42 | $309.03 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | None | $177.83 | $190.55 | $190.55 |
BCBS Arizona Setting Facility Modifier None Typical Low $138.04 Median $602.56 Typical High $912.01 | Facility | None | $138.04 | $602.56 | $912.01 |
BCBS Arizona Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $239.88 | Professional | None | $158.49 | $158.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $302.00 Typical High $323.59 | Facility | None | $213.80 | $302.00 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $204.17 Typical High $257.04 | Facility | None | $158.49 | $204.17 | $257.04 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | None | $162.18 | $162.18 | $173.78 |
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 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $89.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $36.31 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $19.05 |
Where Arizona sits
Rates are fairly even across states for this service. 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· 51st of 51
$166
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.