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 $4.27 Median $16.60 Typical High $21.88 | Facility | None | $4.27 | $16.60 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $5.37 | Professional | None | $4.17 | $4.27 | $5.37 |
BCBS Arizona Setting Facility Modifier None Typical Low $4.17 Median $13.49 Typical High $51.29 | Facility | None | $4.17 | $13.49 | $51.29 |
BCBS Arizona Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $50.12 | Professional | None | $10.00 | $10.00 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $6.92 Typical High $7.24 | Facility | None | $4.79 | $6.92 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Medica Setting Facility Modifier None Typical Low $1.62 Median $4.79 Typical High $6.31 | Facility | None | $1.62 | $4.79 | $6.31 |
Medica Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Where Arizona sits
The same service costs 3.2 times more in Hawaii than in Georgia. 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· 11th of 51
$8.71
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.