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 $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
BCBS Arizona Setting Facility Modifier None Typical Low $2.45 Median $10.96 Typical High $16.60 | Facility | None | $2.45 | $10.96 | $16.60 |
BCBS Arizona Setting Professional Modifier None Typical Low $7.08 Median $8.13 Typical High $14.79 | Professional | None | $7.08 | $8.13 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Medica Setting Facility Modifier None Typical Low $5.50 Median $9.12 Typical High $79.43 | Facility | None | $5.50 | $9.12 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $45.71 | Professional | None | $3.55 | $5.13 | $45.71 |
United Setting Professional Modifier None Typical Low $3.47 Median $3.89 Typical High $5.75 | Professional | None | $3.47 | $3.89 | $5.75 |
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 $2.75 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.55 |
Where Arizona sits
The same service costs 2.3 times more in Kansas than in Alabama. 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· 32nd of 51
$5.50
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.