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 $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Arizona Setting Facility Modifier None Typical Low $154.88 Median $691.83 Typical High $1,047.13 | Facility | None | $154.88 | $691.83 | $1,047.13 |
BCBS Arizona Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $933.25 | Professional | None | $446.68 | $512.86 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $575.44 Typical High $3,090.30 | Facility | None | $263.03 | $575.44 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $3,630.78 | Professional | None | $269.15 | $416.87 | $3,630.78 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Facility | None | $229.09 | $229.09 | $288.40 |
United Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $436.52 | Professional | None | $269.15 | $288.40 | $436.52 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Arizona sits
The same service costs 2.3 times more in Wisconsin 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· 38th of 51
$363
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.