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 $218.78 Median $218.78 Typical High $263.03 | Professional | None | $218.78 | $218.78 | $263.03 |
BCBS Arizona Setting Facility Modifier None Typical Low $144.54 Median $660.69 Typical High $1,000.00 | Facility | None | $144.54 | $660.69 | $1,000.00 |
BCBS Arizona Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $870.96 | Professional | None | $426.58 | $489.78 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $549.54 Typical High $2,238.72 | Facility | None | $234.42 | $549.54 | $2,238.72 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $3,715.35 | Professional | None | $190.55 | $245.47 | $3,715.35 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $309.03 | Professional | None | $186.21 | $204.17 | $309.03 |
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 $109.65 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $21.88 |
Where Arizona sits
The same service costs 4.7 times more in Hawaii 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· 44th 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.