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 $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $10.96 Typical High $10.96 | Professional | None | $6.17 | $10.96 | $10.96 |
BCBS Arizona Setting Facility Modifier None Typical Low $3.24 Median $14.79 Typical High $22.39 | Facility | None | $3.24 | $14.79 | $22.39 |
BCBS Arizona Setting Professional Modifier None Typical Low $9.55 Median $10.96 Typical High $19.50 | Professional | None | $9.55 | $10.96 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | None | $6.92 | $6.92 | $8.13 |
Medica Setting Facility Modifier None Typical Low $8.32 Median $26.92 Typical High $79.43 | Facility | None | $8.32 | $26.92 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $66.07 | Professional | None | $5.25 | $6.92 | $66.07 |
United Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $8.71 | Professional | None | $5.25 | $5.75 | $8.71 |
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 $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
Where Arizona sits
The same service costs 2.2 times more in Hawaii than in Maine. 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
$8.13
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.