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 $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
BCBS Arizona Setting Facility Modifier None Typical Low $3.55 Median $15.14 Typical High $22.91 | Facility | None | $3.55 | $15.14 | $22.91 |
BCBS Arizona Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $15.14 | Professional | None | $6.46 | $6.46 | $15.14 |
Medica Setting Facility Modifier None Typical Low $1.05 Median $1.15 Typical High $100.00 | Facility | None | $1.05 | $1.15 | $100.00 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $109.65 | Professional | None | $66.07 | $66.07 | $109.65 |
United Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $109.65 | Professional | None | $43.65 | $66.07 | $109.65 |
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 $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Arizona sits
The same service costs 177.8 times more in Texas than in Georgia. 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· 41st of 51
$20.42
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.