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 $1.48 Median $1.62 Typical High $2.14 | Facility | None | $1.48 | $1.62 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $1.07 Median $1.12 Typical High $1.41 | Professional | None | $1.07 | $1.12 | $1.41 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.87 Median $3.89 Typical High $5.89 | Facility | None | $0.87 | $3.89 | $5.89 |
BCBS Arizona Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $6.92 | Professional | None | $0.98 | $0.98 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $1.26 Median $1.78 Typical High $1.91 | Facility | None | $1.26 | $1.78 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.20 Typical High $1.55 | Facility | None | $1.00 | $1.20 | $1.55 |
Medica Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.10 | Professional | None | $1.00 | $1.00 | $1.10 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.12 | Professional | None | $1.02 | $1.02 | $1.12 |
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 $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Arizona sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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
$1.58
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.