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 $165.96 Median $208.93 Typical High $208.93 | Professional | None | $165.96 | $208.93 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $239.88 | Professional | None | $173.78 | $190.55 | $239.88 |
BCBS Arizona Setting Facility Modifier None Typical Low $131.83 Median $575.44 Typical High $851.14 | Facility | None | $131.83 | $575.44 | $851.14 |
BCBS Arizona Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $165.96 | Professional | None | $109.65 | $109.65 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $229.09 Typical High $389.05 | Facility | None | $208.93 | $229.09 | $389.05 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $1,174.90 | Professional | None | $162.18 | $275.42 | $1,174.90 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $281.84 | Professional | None | $158.49 | $223.87 | $281.84 |
5 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 $100.00 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.95 | $20.89 | $20.89 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 59 · Distinct service | $169.82 | $169.82 | $169.82 |
Where Arizona sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 26th of 51
$209
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.