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 $190.55 Median $190.55 Typical High $257.04 | Professional | None | $190.55 | $190.55 | $257.04 |
BCBS Arizona Setting Facility Modifier None Typical Low $151.36 Median $467.74 Typical High $1,000.00 | Facility | None | $151.36 | $467.74 | $1,000.00 |
BCBS Arizona Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $1,288.25 | Professional | None | $186.21 | $186.21 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $346.74 | Facility | None | $234.42 | $331.13 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $275.42 | Facility | None | $162.18 | $208.93 | $275.42 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $194.98 | Professional | None | $169.82 | $181.97 | $194.98 |
United Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $213.80 | Professional | None | $190.55 | $204.17 | $213.80 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Where Arizona sits
The same service costs 6.3 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
$251
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.