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 $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $45.71 | Professional | None | $32.36 | $32.36 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $45.71 | Professional | None | $25.70 | $30.90 | $45.71 |
BCBS Arizona Setting Facility Modifier None Typical Low $26.30 Median $114.82 Typical High $173.78 | Facility | None | $26.30 | $114.82 | $173.78 |
BCBS Arizona Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $204.17 | Professional | None | $28.84 | $28.84 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $60.26 Typical High $63.10 | Facility | None | $42.66 | $60.26 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $30.90 Typical High $44.67 | Facility | None | $26.30 | $30.90 | $44.67 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $36.31 | Professional | None | $33.88 | $35.48 | $36.31 |
United Setting Professional Modifier None Typical Low $35.48 Median $36.31 Typical High $37.15 | Professional | None | $35.48 | $36.31 | $37.15 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where Arizona sits
The same service costs 5.4 times more in Arizona than in Rhode Island. 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
$45.71
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.