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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $138.04 | Professional | None | $75.86 | $83.18 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $74.13 | Professional | None | $53.70 | $70.79 | $74.13 |
BCBS Arizona Setting Facility Modifier None Typical Low $63.10 Median $281.84 Typical High $426.58 | Facility | None | $63.10 | $281.84 | $426.58 |
BCBS Arizona Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $501.19 | Professional | None | $70.79 | $70.79 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $173.78 | Facility | None | $117.49 | $165.96 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $104.71 | Facility | None | $72.44 | $72.44 | $104.71 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $100.00 | Professional | None | $95.50 | $97.72 | $100.00 |
United Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | None | $95.50 | $100.00 | $102.33 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Arizona sits
The same service costs 2.9 times more in Arizona than in Alabama. 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· 1st of 51
$115
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.