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 $2.19 Median $2.40 Typical High $3.16 | Facility | None | $2.19 | $2.40 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
BCBS Arizona Setting Facility Modifier None Typical Low $1.32 Median $5.75 Typical High $9.12 | Facility | None | $1.32 | $5.75 | $9.12 |
BCBS Arizona Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $10.23 | Professional | None | $1.45 | $1.45 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $2.63 Typical High $2.82 | Facility | None | $1.86 | $2.63 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Medica Setting Facility Modifier None Typical Low $1.23 Median $1.82 Typical High $2.40 | Facility | None | $1.23 | $1.82 | $2.40 |
Medica Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
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 $0.83 Median $0.83 Typical High $0.83 | Professional | 52 · Reduced service | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.17 |
Where Arizona sits
The same service costs 1.7 times more in Arizona than in North Carolina. 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
$2.57
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.