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 $16.22 Median $21.38 Typical High $23.99 | Facility | None | $16.22 | $21.38 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $12.02 Typical High $16.22 | Professional | None | $11.22 | $12.02 | $16.22 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
BCBS Arizona Setting Facility Modifier None Typical Low $9.55 Median $42.66 Typical High $64.57 | Facility | None | $9.55 | $42.66 | $64.57 |
BCBS Arizona Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $75.86 | Professional | None | $10.96 | $10.96 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $19.50 Typical High $20.89 | Facility | None | $13.80 | $19.50 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Medica Setting Facility Modifier None Typical Low $10.72 Median $14.45 Typical High $75.86 | Facility | None | $10.72 | $14.45 | $75.86 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $6.03 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Where Arizona sits
The same service costs 3.7 times more in Wyoming 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· 5th of 51
$17.38
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.