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 $1.10 Median $1.45 Typical High $2.04 | Facility | None | $1.10 | $1.45 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.10 Typical High $2.29 | Professional | None | $1.00 | $1.10 | $2.29 |
Ambetter Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
BCBS Arizona Setting Facility Modifier None Typical Low $0.78 Median $3.39 Typical High $5.25 | Facility | None | $0.78 | $3.39 | $5.25 |
BCBS Arizona Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $6.17 | Professional | None | $0.85 | $0.85 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $1.23 Median $1.74 Typical High $1.86 | Facility | None | $1.23 | $1.74 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Medica Setting Facility Modifier None Typical Low $0.95 Median $1.12 Typical High $3.02 | Facility | None | $0.95 | $1.12 | $3.02 |
Medica Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
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 $0.55 Median $0.55 Typical High $0.55 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Arizona sits
The same service costs 2.5 times more in Texas than in Maryland. 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
$1.48
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.