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 $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
BCBS Arizona Setting Facility Modifier None Typical Low $177.83 Median $812.83 Typical High $1,230.27 | Facility | None | $177.83 | $812.83 | $1,230.27 |
BCBS Arizona Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,096.48 | Professional | None | $524.81 | $602.56 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,412.54 Typical High $3,235.94 | Facility | None | $295.12 | $1,412.54 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $3,467.37 | Professional | None | $288.40 | $371.54 | $3,467.37 |
United Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $489.78 | Professional | None | $288.40 | $309.03 | $489.78 |
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 $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
Where Arizona sits
The same service costs 2.3 times more in Montana than in Delaware. 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· 50th of 51
$316
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.