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 Facility Modifier None Typical Low $977.24 Median $3,715.35 Typical High $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $6.03 Typical High $12.88 | Professional | None | $2.51 | $6.03 | $12.88 |
BCBS Arizona Setting Facility Modifier None Typical Low $5.89 Median $26.92 Typical High $40.74 | Facility | None | $5.89 | $26.92 | $40.74 |
BCBS Arizona Setting Professional Modifier None Typical Low $5.62 Median $8.91 Typical High $12.59 | Professional | None | $5.62 | $8.91 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $16.60 Typical High $21.38 | Facility | None | $1.82 | $16.60 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $11.75 | Professional | None | $1.26 | $1.26 | $11.75 |
Medica Setting Facility Modifier None Typical Low $3.31 Median $6.92 Typical High $75.86 | Facility | None | $3.31 | $6.92 | $75.86 |
Medica Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $3.16 | Professional | None | $1.26 | $1.26 | $3.16 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $3.89 | Professional | None | $1.26 | $1.26 | $3.89 |
5 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 $3.02 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 54 · Surgery only | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Where Arizona sits
The same service costs 25.7 times more in Kansas than in Delaware. 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· 16th of 51
$8.13
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.