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 $19.05 Median $158.49 Typical High $302.00 | Professional | None | $19.05 | $158.49 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $14.45 Median $102.33 Typical High $316.23 | Professional | None | $14.45 | $102.33 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $52.48 Typical High $354.81 | Professional | None | $20.42 | $52.48 | $354.81 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $95.50 Typical High $380.19 | Facility | None | $19.95 | $95.50 | $380.19 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $2,454.71 | Professional | None | $138.04 | $275.42 | $2,454.71 |
United Setting Professional Modifier None Typical Low $19.95 Median $173.78 Typical High $346.74 | Professional | None | $19.95 | $173.78 | $346.74 |
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 $9.55 Median $25.12 Typical High $151.36 | Professional | 52 · Reduced service | $9.55 | $25.12 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $10.00 Typical High $60.26 | Professional | 53 · Discontinued | $3.80 | $10.00 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $7.59 Typical High $45.71 | Professional | 55 · Aftercare only | $2.88 | $7.59 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $5.01 Typical High $30.20 | Professional | 56 · Pre-op care only | $1.91 | $5.01 | $30.20 |
Where Arizona sits
The same service costs 17.4 times more in Hawaii than in Washington, DC. 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· 27th of 51
$170
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.