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 $245.47 Median $245.47 Typical High $269.15 | Professional | None | $245.47 | $245.47 | $269.15 |
BCBS Arizona Setting Facility Modifier None Typical Low $52.48 Median $204.17 Typical High $338.84 | Facility | None | $52.48 | $204.17 | $338.84 |
BCBS Arizona Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | None | $165.96 | $165.96 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $831.76 | Facility | None | $245.47 | $269.15 | $831.76 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $3,388.44 | Professional | None | $269.15 | $501.19 | $3,388.44 |
United Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $501.19 | Professional | None | $257.04 | $281.84 | $501.19 |
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 $123.03 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $26.92 |
Where Arizona sits
The same service costs 17.0 times more in Iowa than in Kentucky. 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· 46th of 51
$282
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.