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 $1.45 Median $1.62 Typical High $2.14 | Facility | None | $1.45 | $1.62 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | None | $0.95 | $0.95 | $0.95 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.85 Median $3.80 Typical High $5.75 | Facility | None | $0.85 | $3.80 | $5.75 |
BCBS Arizona Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $6.76 | Professional | None | $0.98 | $0.98 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $1.07 Median $1.51 Typical High $1.58 | Facility | None | $1.07 | $1.51 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Medica Setting Facility Modifier None Typical Low $0.74 Median $0.98 Typical High $1.15 | Facility | None | $0.74 | $0.98 | $1.15 |
Medica Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | None | $0.74 | $0.74 | $0.74 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
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 $0.48 Median $0.48 Typical High $0.48 | Professional | 52 · Reduced service | $0.48 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 53 · Discontinued | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where Arizona sits
The same service costs 4.1 times more in Oklahoma than in North Dakota. 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· 6th of 51
$1.51
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.