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 $0.38 Median $0.38 Typical High $0.41 | Professional | None | $0.38 | $0.38 | $0.41 |
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 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.26 Median $1.02 Typical High $1.66 | Facility | None | $0.26 | $1.02 | $1.66 |
BCBS Arizona Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.20 | Professional | None | $0.79 | $0.79 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Medica Setting Facility Modifier None Typical Low $0.38 Median $0.42 Typical High $1.29 | Facility | None | $0.38 | $0.42 | $1.29 |
Medica Setting Professional Modifier None Typical Low $0.43 Median $0.76 Typical High $5.25 | Professional | None | $0.43 | $0.76 | $5.25 |
United Setting Professional Modifier None Typical Low $0.40 Median $0.43 Typical High $0.76 | Professional | None | $0.40 | $0.43 | $0.76 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | Q6 · Substitute physician, paid per time | $1.51 | $1.51 | $1.51 |
Where Arizona sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 15th of 51
$0.76
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.