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 $4.68 Median $5.25 Typical High $6.92 | Facility | None | $4.68 | $5.25 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
BCBS Arizona Setting Facility Modifier None Typical Low $2.82 Median $12.30 Typical High $19.50 | Facility | None | $2.82 | $12.30 | $19.50 |
BCBS Arizona Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $21.88 | Professional | None | $3.09 | $3.09 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $5.62 Typical High $7.41 | Facility | None | $3.98 | $5.62 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.89 Typical High $5.13 | Facility | None | $3.24 | $3.89 | $5.13 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
5 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 $1.78 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 54 · Surgery only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Where Arizona sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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
$5.50
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.