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 $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
BCBS Arizona Setting Facility Modifier None Typical Low $8,128.31 Median $36,307.81 Typical High $54,954.09 | Facility | None | $8,128.31 | $36,307.81 | $54,954.09 |
BCBS Arizona Setting Professional Modifier None Typical Low $7,943.28 Median $9,120.11 Typical High $16,595.87 | Professional | None | $7,943.28 | $9,120.11 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Medica Setting Facility Modifier None Typical Low $5,128.61 Median $20,892.96 Typical High $44,668.36 | Facility | None | $5,128.61 | $20,892.96 | $44,668.36 |
Medica Setting Professional Modifier None Typical Low $4,265.80 Median $7,079.46 Typical High $51,286.14 | Professional | None | $4,265.80 | $7,079.46 | $51,286.14 |
United Setting Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $7,079.46 | Professional | None | $4,265.80 | $4,570.88 | $7,079.46 |
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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $467.74 | $467.74 | $467.74 |
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· 28th of 51
$5,623
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.