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 $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS Arizona Setting Facility Modifier None Typical Low $177.83 Median $794.33 Typical High $1,202.26 | Facility | None | $177.83 | $794.33 | $1,202.26 |
BCBS Arizona Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $1,071.52 | Professional | None | $512.86 | $588.84 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $660.69 Typical High $2,884.03 | Facility | None | $302.00 | $660.69 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $3,311.31 | Professional | None | $275.42 | $426.58 | $3,311.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $457.09 | Professional | None | $275.42 | $302.00 | $457.09 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Where Arizona sits
The same service costs 2.6 times more in Montana than in New York. 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· 36th 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.