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 $5.13 Median $5.25 Typical High $10.00 | Facility | None | $5.13 | $5.25 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $10.00 Typical High $10.00 | Professional | None | $5.25 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $2.63 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.07 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $0.79 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.52 | $1.00 | $1.00 |
Ambetter Setting Professional Modifier None Typical Low $3.63 Median $4.37 Typical High $4.79 | Professional | None | $3.63 | $4.37 | $4.79 |
BCBS Arizona Setting Facility Modifier None Typical Low $5.25 Median $18.62 Typical High $36.31 | Facility | None | $5.25 | $18.62 | $36.31 |
BCBS Arizona Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.57 | Professional | None | $3.16 | $3.16 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $4.07 Typical High $6.61 | Professional | None | $3.02 | $4.07 | $6.61 |
Medica Setting Facility Modifier None Typical Low $6.61 Median $10.00 Typical High $14.45 | Facility | None | $6.61 | $10.00 | $14.45 |
Medica Setting Professional Modifier None Typical Low $4.57 Median $29.51 Typical High $29.51 | Professional | None | $4.57 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $4.37 Median $5.25 Typical High $7.94 | Professional | None | $4.37 | $5.25 | $7.94 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.89 Median $4.57 Typical High $5.01 | Professional | 59 · Distinct service | $3.89 | $4.57 | $5.01 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | EP · Child screening program | $4.79 | $4.79 | $4.79 |
Where Arizona sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 28th of 51
$5.01
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.