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 $4.57 Median $5.13 Typical High $6.76 | Facility | None | $4.57 | $5.13 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $3.72 | Professional | None | $3.47 | $3.55 | $3.72 |
BCBS Arizona Setting Facility Modifier None Typical Low $2.63 Median $11.75 Typical High $17.78 | Facility | None | $2.63 | $11.75 | $17.78 |
BCBS Arizona Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $21.38 | Professional | None | $3.09 | $3.09 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $5.75 Typical High $6.17 | Facility | None | $4.07 | $5.75 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $3.72 Typical High $4.79 | Facility | None | $3.02 | $3.72 | $4.79 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
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 $1.78 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Where Arizona sits
The same service costs 2.0 times more in Arizona than in Oklahoma. 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
$5.13
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.