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 $15.85 Median $25.70 Typical High $32.36 | Professional | None | $15.85 | $25.70 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
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 $6.17 Median $6.17 Typical High $10.00 | Professional | None | $6.17 | $6.17 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $18.20 Typical High $66.07 | Facility | None | $13.80 | $18.20 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $26.92 Typical High $43.65 | Professional | None | $16.60 | $26.92 | $43.65 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $316.23 Typical High $1,584.89 | Facility | None | $28.18 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $128.82 Typical High $208.93 | Professional | None | $26.92 | $128.82 | $208.93 |
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 $16.98 Median $28.84 Typical High $41.69 | Professional | None | $16.98 | $28.84 | $41.69 |
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 $7.94 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $7.94 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $3.16 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $2.34 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.58 | $2.57 | $2.57 |
Where Arizona sits
The same service costs 3.0 times more in Alaska than in Virginia. 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· 38th of 51
$29.51
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.