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 $3.55 Median $3.98 Typical High $5.25 | Facility | None | $3.55 | $3.98 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
BCBS Arizona Setting Facility Modifier None Typical Low $1.66 Median $5.25 Typical High $12.88 | Facility | None | $1.66 | $5.25 | $12.88 |
BCBS Arizona Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $16.98 | Professional | None | $2.40 | $2.40 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $3.98 Typical High $4.27 | Facility | None | $2.82 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Medica Setting Facility Modifier None Typical Low $3.47 Median $4.17 Typical High $5.50 | Facility | None | $3.47 | $4.17 | $5.50 |
Medica Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
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 $1.26 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Where Arizona sits
The same service costs 4.8 times more in Oklahoma 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
$3.55
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.