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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $11.22 Typical High $28.84 | Professional | None | $5.01 | $11.22 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $20.42 | Professional | None | $12.59 | $14.79 | $20.42 |
BCBS Arizona Setting Facility Modifier None Typical Low $6.03 Median $25.70 Typical High $38.90 | Facility | None | $6.03 | $25.70 | $38.90 |
BCBS Arizona Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $102.33 | Professional | None | $14.45 | $14.45 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $13.80 | Professional | None | $8.32 | $12.59 | $13.80 |
Medica Setting Facility Modifier None Typical Low $5.01 Median $7.08 Typical High $30.90 | Facility | None | $5.01 | $7.08 | $30.90 |
Medica Setting Professional Modifier None Typical Low $10.23 Median $12.88 Typical High $16.60 | Professional | None | $10.23 | $12.88 | $16.60 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.02 Typical High $15.85 | Professional | None | $8.71 | $12.02 | $15.85 |
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 $2.51 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.50 | $0.50 | $0.50 |
Where Arizona sits
The same service costs 5.6 times more in Alabama 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· 35th of 51
$13.18
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.