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 $5.89 Median $6.61 Typical High $8.71 | Facility | None | $5.89 | $6.61 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
BCBS Arizona Setting Facility Modifier None Typical Low $3.47 Median $15.49 Typical High $23.44 | Facility | None | $3.47 | $15.49 | $23.44 |
BCBS Arizona Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $27.54 | Professional | None | $3.98 | $3.98 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $7.24 Typical High $7.76 | Facility | None | $5.13 | $7.24 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
Medica Setting Facility Modifier None Typical Low $1.62 Median $4.47 Typical High $6.46 | Facility | None | $1.62 | $4.47 | $6.46 |
Medica Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
United Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
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 $2.29 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | 55 · Aftercare only | $0.69 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.46 | $0.46 | $0.46 |
Where Arizona sits
The same service costs 1.6 times more in Arizona 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· 1st of 51
$6.61
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.