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 $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS Arizona Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $269.15 | Professional | None | $120.23 | $123.03 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $147.91 Typical High $691.83 | Facility | None | $89.13 | $147.91 | $691.83 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $1,288.25 | Professional | None | $58.88 | $67.61 | $1,288.25 |
United Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $102.33 | Professional | None | $58.88 | $63.10 | $102.33 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 54 · Surgery only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where Arizona sits
The same service costs 2.8 times more in Hawaii 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· 30th of 51
$89.13
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.