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 $1.35 Median $1.51 Typical High $2.00 | Facility | None | $1.35 | $1.51 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.07 | Professional | None | $1.05 | $1.05 | $1.07 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.85 Median $3.63 Typical High $5.50 | Facility | None | $0.85 | $3.63 | $5.50 |
BCBS Arizona Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $5.62 | Professional | None | $0.79 | $0.79 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $1.12 Typical High $1.20 | Facility | None | $0.81 | $1.12 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Medica Setting Facility Modifier None Typical Low $0.41 Median $1.12 Typical High $1.48 | Facility | None | $0.41 | $1.12 | $1.48 |
Medica Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
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 $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
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 27.5 times more in Kansas than in New York. 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· 8th of 51
$1.05
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.