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 $190.55 Median $213.80 Typical High $281.84 | Facility | None | $190.55 | $213.80 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $158.49 | Professional | None | $138.04 | $151.36 | $158.49 |
BCBS Arizona Setting Facility Modifier None Typical Low $61.66 Median $204.17 Typical High $691.83 | Facility | None | $61.66 | $204.17 | $691.83 |
BCBS Arizona Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $912.01 | Professional | None | $128.82 | $128.82 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $257.04 | Facility | None | $169.82 | $239.88 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $389.05 | Facility | None | $128.82 | $158.49 | $389.05 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | None | $131.83 | $131.83 | $147.91 |
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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where Arizona sits
The same service costs 5.5 times more in Texas than in Oregon. 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
$151
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.