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 $316.23 Median $354.81 Typical High $467.74 | Facility | None | $316.23 | $354.81 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | None | $234.42 | $251.19 | $251.19 |
BCBS Arizona Setting Facility Modifier None Typical Low $186.21 Median $831.76 Typical High $1,258.93 | Facility | None | $186.21 | $831.76 | $1,258.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $323.59 | Professional | None | $213.80 | $213.80 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $426.58 | Facility | None | $281.84 | $398.11 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $281.84 Typical High $338.84 | Facility | None | $218.78 | $281.84 | $338.84 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $776.25 Typical High $933.25 | Professional | None | $218.78 | $776.25 | $933.25 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | None | $223.87 | $223.87 | $229.09 |
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 $117.49 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $46.77 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $25.12 |
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· 18th 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.