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 $1.07 Median $1.07 Typical High $1.07 | Professional | None | $1.07 | $1.07 | $1.07 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.48 Median $2.19 Typical High $3.31 | Facility | None | $0.48 | $2.19 | $3.31 |
BCBS Arizona Setting Professional Modifier None Typical Low $1.41 Median $1.58 Typical High $2.88 | Professional | None | $1.41 | $1.58 | $2.88 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
Medica Setting Facility Modifier None Typical Low $1.07 Median $1.82 Typical High $79.43 | Facility | None | $1.07 | $1.82 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.71 Median $1.02 Typical High $8.91 | Professional | None | $0.71 | $1.02 | $8.91 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.78 Typical High $1.15 | Professional | None | $0.71 | $0.78 | $1.15 |
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 $0.54 Median $0.54 Typical High $0.54 | Professional | 52 · Reduced service | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Arizona sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 36th of 51
$1.07
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.