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 $0.21 Median $0.37 Typical High $0.37 | Professional | None | $0.21 | $0.37 | $0.37 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.02 | Professional | None | $25.70 | $25.70 | $38.02 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.37 Median $1.07 Typical High $2.75 | Facility | None | $0.37 | $1.07 | $2.75 |
BCBS Arizona Setting Professional Modifier None Typical Low $0.44 Median $0.45 Typical High $1.00 | Professional | None | $0.44 | $0.45 | $1.00 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Medica Setting Facility Modifier None Typical Low $0.37 Median $0.48 Typical High $1.26 | Facility | None | $0.37 | $0.48 | $1.26 |
Medica Setting Professional Modifier None Typical Low $0.25 Median $0.26 Typical High $4.27 | Professional | None | $0.25 | $0.26 | $4.27 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.26 Typical High $0.38 | Professional | None | $0.25 | $0.26 | $0.38 |
5 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 $0.19 Median $0.19 Typical High $0.19 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.17 | Professional | RR · Rental | $0.04 | $0.04 | $0.17 |
Where Arizona sits
The same service costs 4.6 times more in Hawaii 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· 25th of 51
$0.37
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.