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 $4.57 Median $5.89 Typical High $12.02 | Facility | None | $4.57 | $5.89 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $4.37 Typical High $6.76 | Professional | None | $2.95 | $4.37 | $6.76 |
BCBS Arizona Setting Facility Modifier None Typical Low $3.09 Median $13.49 Typical High $20.89 | Facility | None | $3.09 | $13.49 | $20.89 |
BCBS Arizona Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $24.55 | Professional | None | $3.47 | $3.47 | $24.55 |
Medica Setting Facility Modifier None Typical Low $3.98 Median $10.00 Typical High $13.18 | Facility | None | $3.98 | $10.00 | $13.18 |
Medica Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.37 | Professional | None | $3.98 | $3.98 | $4.37 |
United Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.17 | Professional | None | $3.63 | $3.63 | $4.17 |
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 $3.39 Median $3.39 Typical High $3.39 | Professional | 52 · Reduced service | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | 53 · Discontinued | $1.35 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | 55 · Aftercare only | $1.02 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.68 | $0.68 | $0.68 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | JZ · No drug discarded | $4.27 | $4.27 | $4.27 |
Where Arizona sits
The same service costs 2.8 times more in Wyoming than in Florida. 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· 3rd of 51
$6.76
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.