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 Facility Modifier None Typical Low $5.01 Median $5.62 Typical High $7.41 | Facility | None | $5.01 | $5.62 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
BCBS Arizona Setting Facility Modifier None Typical Low $3.09 Median $13.49 Typical High $21.38 | Facility | None | $3.09 | $13.49 | $21.38 |
BCBS Arizona Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $23.99 | Professional | None | $3.39 | $3.39 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $4.37 Median $6.17 Typical High $6.61 | Facility | None | $4.37 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $4.37 Typical High $5.62 | Facility | None | $3.55 | $4.37 | $5.62 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
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 $1.95 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 55 · Aftercare only | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.39 |
Where Arizona sits
The same service costs 1.7 times more in Arizona than in Illinois. 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· 1st of 51
$6.03
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.