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 $2.00 Median $2.19 Typical High $2.88 | Facility | None | $2.00 | $2.19 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | None | $1.55 | $1.55 | $1.55 |
BCBS Arizona Setting Facility Modifier None Typical Low $1.20 Median $5.37 Typical High $8.32 | Facility | None | $1.20 | $5.37 | $8.32 |
BCBS Arizona Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $9.33 | Professional | None | $1.32 | $1.32 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $2.45 Typical High $2.63 | Facility | None | $1.74 | $2.45 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Medica Setting Facility Modifier None Typical Low $0.81 Median $1.62 Typical High $2.09 | Facility | None | $0.81 | $1.62 | $2.09 |
Medica Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
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 $0.78 Median $0.78 Typical High $0.78 | Professional | 52 · Reduced service | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 53 · Discontinued | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Where Arizona sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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
$2.34
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.