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 $3.72 Median $4.17 Typical High $5.50 | Facility | None | $3.72 | $4.17 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
BCBS Arizona Setting Facility Modifier None Typical Low $2.24 Median $10.00 Typical High $15.14 | Facility | None | $2.24 | $10.00 | $15.14 |
BCBS Arizona Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $17.78 | Professional | None | $2.51 | $2.51 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $4.68 Typical High $5.01 | Facility | None | $3.31 | $4.68 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Medica Setting Facility Modifier None Typical Low $2.51 Median $3.16 Typical High $4.07 | Facility | None | $2.51 | $3.16 | $4.07 |
Medica Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
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 $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Where Arizona sits
The same service costs 1.7 times more in Arizona 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· 1st of 51
$4.37
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.