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 $57.54 Median $67.61 Typical High $67.61 | Professional | None | $57.54 | $67.61 | $67.61 |
BCBS Arizona Setting Facility Modifier None Typical Low $21.88 Median $100.00 Typical High $151.36 | Facility | None | $21.88 | $100.00 | $151.36 |
BCBS Arizona Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $97.72 | Professional | None | $54.95 | $74.13 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $177.83 Typical High $426.58 | Facility | None | $67.61 | $177.83 | $426.58 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $93.33 Typical High $478.63 | Professional | None | $45.71 | $93.33 | $478.63 |
United Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $93.33 | Professional | None | $45.71 | $54.95 | $93.33 |
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 $28.84 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $28.84 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $11.48 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $8.71 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.75 | $6.76 | $6.76 |
Where Arizona sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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· 20th of 51
$67.61
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.