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 $45.71 Median $50.12 Typical High $66.07 | Facility | None | $45.71 | $50.12 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $34.67 Typical High $36.31 | Professional | None | $32.36 | $34.67 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
BCBS Arizona Setting Facility Modifier None Typical Low $15.14 Median $50.12 Typical High $165.96 | Facility | None | $15.14 | $50.12 | $165.96 |
BCBS Arizona Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $213.80 | Professional | None | $30.20 | $30.20 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $54.95 Typical High $60.26 | Facility | None | $39.81 | $54.95 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $75.86 | Facility | None | $31.62 | $41.69 | $75.86 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
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 $17.38 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.47 |
Where Arizona sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 15th of 51
$35.48
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.