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 $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
BCBS Setting Facility Modifier None Typical Low $123.03 Median $562.34 Typical High $851.14 | Facility | None | $123.03 | $562.34 | $851.14 |
BCBS Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $741.31 | Professional | None | $354.81 | $407.38 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $501.19 Typical High $2,570.40 | Facility | None | $223.87 | $501.19 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $3,311.31 | Professional | None | $229.09 | $354.81 | $3,311.31 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Facility | None | $173.78 | $173.78 | $251.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $380.19 | Professional | None | $223.87 | $251.19 | $380.19 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
Where Arizona sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 37th of 51
$302
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.