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 $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS Arizona Setting Facility Modifier None Typical Low $91.20 Median $416.87 Typical High $630.96 | Facility | None | $91.20 | $416.87 | $630.96 |
BCBS Arizona Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $562.34 | Professional | None | $269.15 | $309.03 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $346.74 Typical High $1,737.80 | Facility | None | $154.88 | $346.74 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $1,862.09 | Professional | None | $154.88 | $239.88 | $1,862.09 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $251.19 | Professional | None | $154.88 | $169.82 | $251.19 |
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 $77.62 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $15.49 |
Where Arizona sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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
$204
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.