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 Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $275.42 | Professional | None | $117.49 | $117.49 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $316.23 | Professional | None | $309.03 | $309.03 | $316.23 |
BCBS Setting Facility Modifier None Typical Low $56.23 Median $251.19 Typical High $380.19 | Facility | None | $56.23 | $251.19 | $380.19 |
BCBS Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $338.84 | Professional | None | $162.18 | $186.21 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $602.56 Typical High $1,348.96 | Facility | None | $117.49 | $602.56 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $2,041.74 | Professional | None | $208.93 | $239.88 | $2,041.74 |
United Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $346.74 | Professional | None | $147.91 | $218.78 | $346.74 |
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 $58.88 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $11.75 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Where Arizona sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 45th of 51
$219
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.