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 $8.51 Median $13.18 Typical High $17.38 | Facility | None | $8.51 | $13.18 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $8.51 Typical High $8.91 | Professional | None | $7.76 | $8.51 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Professional | None | $6.17 | $6.17 | $6.61 |
BCBS Arizona Setting Facility Modifier None Typical Low $10.72 Median $34.67 Typical High $66.07 | Facility | None | $10.72 | $34.67 | $66.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $56.23 | Professional | None | $7.94 | $7.94 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $14.45 | Facility | None | $9.55 | $13.49 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Medica Setting Facility Modifier None Typical Low $8.51 Median $12.59 Typical High $21.88 | Facility | None | $8.51 | $12.59 | $21.88 |
Medica Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
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 $4.27 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
Where Arizona sits
The same service costs 2.6 times more in Texas 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· 4th of 51
$12.59
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.