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 $190.55 Median $199.53 Typical High $199.53 | Professional | None | $190.55 | $199.53 | $199.53 |
BCBS Arizona Setting Facility Modifier None Typical Low $48.98 Median $117.49 Typical High $309.03 | Facility | None | $48.98 | $117.49 | $309.03 |
BCBS Arizona Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $223.87 | Professional | None | $97.72 | $100.00 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $263.03 | Facility | None | $125.89 | $177.83 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $501.19 | Facility | None | $177.83 | $218.78 | $501.19 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $812.83 | Professional | None | $181.97 | $181.97 | $812.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $95.50 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $38.02 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.05 | $19.95 | $19.95 |
Where Arizona sits
The same service costs 3.6 times more in Wyoming than in North Carolina. 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· 32nd of 51
$174
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.