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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS Arizona Setting Facility Modifier None Typical Low $162.18 Median $741.31 Typical High $1,122.02 | Facility | None | $162.18 | $741.31 | $1,122.02 |
BCBS Arizona Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $977.24 | Professional | None | $478.63 | $537.03 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | None | $257.04 | $257.04 | $354.81 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $616.60 Typical High $2,454.71 | Facility | None | $263.03 | $616.60 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $3,388.44 | Professional | None | $208.93 | $295.12 | $3,388.44 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $309.03 | Facility | None | $234.42 | $234.42 | $309.03 |
United Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $346.74 | Professional | None | $208.93 | $229.09 | $346.74 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where Arizona sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 41st of 51
$257
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.