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 $40.74 Median $40.74 Typical High $46.77 | Facility | None | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $69.18 | Professional | None | $40.74 | $44.67 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $48.98 | Professional | None | $32.36 | $38.02 | $48.98 |
BCBS Arizona Setting Facility Modifier None Typical Low $31.62 Median $138.04 Typical High $204.17 | Facility | None | $31.62 | $138.04 | $204.17 |
BCBS Arizona Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $263.03 | Professional | None | $37.15 | $37.15 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $95.50 | Facility | None | $63.10 | $89.13 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Medica Setting Facility Modifier None Typical Low $23.99 Median $36.31 Typical High $52.48 | Facility | None | $23.99 | $36.31 | $52.48 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $51.29 | Professional | None | $47.86 | $48.98 | $51.29 |
United Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $54.95 | Professional | None | $51.29 | $52.48 | $54.95 |
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 $20.42 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
Where Arizona sits
The same service costs 6.0 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
$57.54
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.