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 $288.40 Median $323.59 Typical High $416.87 | Facility | None | $288.40 | $323.59 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | None | $208.93 | $223.87 | $223.87 |
BCBS Arizona Setting Facility Modifier None Typical Low $162.18 Median $537.03 Typical High $1,047.13 | Facility | None | $162.18 | $537.03 | $1,047.13 |
BCBS Arizona Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $295.12 | Professional | None | $194.98 | $194.98 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $389.05 | Facility | None | $257.04 | $363.08 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $257.04 Typical High $309.03 | Facility | None | $199.53 | $257.04 | $309.03 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $478.63 Typical High $851.14 | Professional | None | $199.53 | $478.63 | $851.14 |
United Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | None | $199.53 | $199.53 | $204.17 |
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 $107.15 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $32.36 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $22.39 |
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· 32nd of 51
$204
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.