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 $70.79 Median $70.79 Typical High $104.71 | Facility | None | $70.79 | $70.79 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $117.49 | Professional | None | $63.10 | $91.20 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $158.49 | Professional | None | $102.33 | $102.33 | $158.49 |
BCBS Arizona Setting Facility Modifier None Typical Low $128.82 Median $302.00 Typical High $794.33 | Facility | None | $128.82 | $302.00 | $794.33 |
BCBS Arizona Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $169.82 | Professional | None | $77.62 | $128.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $154.88 | Facility | None | $66.07 | $83.18 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $125.89 | Professional | None | $61.66 | $81.28 | $125.89 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $323.59 Typical High $1,584.89 | Facility | None | $89.13 | $323.59 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $501.19 Typical High $724.44 | Professional | None | $83.18 | $501.19 | $724.44 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $120.23 | Professional | None | $58.88 | $79.43 | $120.23 |
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 $30.90 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $30.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $12.59 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.31 | $7.76 | $9.12 |
Where Arizona sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 37th of 51
$91.20
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.