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 $37.15 Median $63.10 Typical High $154.88 | Facility | None | $37.15 | $63.10 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $85.11 | Professional | None | $37.15 | $63.10 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $48.98 Typical High $93.33 | Professional | None | $25.70 | $48.98 | $93.33 |
BCBS Arizona Setting Facility Modifier None Typical Low $57.54 Median $134.90 Typical High $354.81 | Facility | None | $57.54 | $134.90 | $354.81 |
BCBS Arizona Setting Professional Modifier None Typical Low $48.98 Median $95.50 Typical High $123.03 | Professional | None | $48.98 | $95.50 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $616.60 | Facility | None | $56.23 | $66.07 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $81.28 | Professional | None | $37.15 | $56.23 | $81.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $309.03 Typical High $1,659.59 | Facility | None | $54.95 | $309.03 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $302.00 Typical High $501.19 | Professional | None | $56.23 | $302.00 | $501.19 |
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 $34.67 Median $54.95 Typical High $79.43 | Professional | None | $34.67 | $54.95 | $79.43 |
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 $18.62 Median $28.18 Typical High $30.90 | Professional | 52 · Reduced service | $18.62 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $11.22 Typical High $12.59 | Professional | 53 · Discontinued | $7.41 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $8.32 Typical High $9.33 | Professional | 55 · Aftercare only | $5.50 | $8.32 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.62 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.72 | $5.62 | $6.31 |
Where Arizona sits
The same service costs 4.0 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
$63.10
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.