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 $1.55 Median $1.55 Typical High $1.55 | Professional | None | $1.55 | $1.55 | $1.55 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.69 Median $3.09 Typical High $4.68 | Facility | None | $0.69 | $3.09 | $4.68 |
BCBS Arizona Setting Professional Modifier None Typical Low $2.04 Median $2.29 Typical High $4.17 | Professional | None | $2.04 | $2.29 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Medica Setting Facility Modifier None Typical Low $1.55 Median $2.57 Typical High $79.43 | Facility | None | $1.55 | $2.57 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.02 Median $1.48 Typical High $12.88 | Professional | None | $1.02 | $1.48 | $12.88 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.10 Typical High $1.66 | Professional | None | $1.00 | $1.10 | $1.66 |
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 $0.78 Median $0.78 Typical High $0.78 | Professional | 52 · Reduced service | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 53 · Discontinued | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Where Arizona sits
The same service costs 2.3 times more in Kansas 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· 35th of 51
$1.55
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.