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 $72.44 Median $89.13 Typical High $117.49 | Facility | None | $72.44 | $89.13 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | None | $57.54 | $63.10 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | None | $57.54 | $66.07 | $66.07 |
BCBS Arizona Setting Facility Modifier None Typical Low $46.77 Median $204.17 Typical High $302.00 | Facility | None | $46.77 | $204.17 | $302.00 |
BCBS Arizona Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $79.43 | Professional | None | $52.48 | $52.48 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $107.15 | Facility | None | $70.79 | $100.00 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $72.44 Typical High $85.11 | Facility | None | $53.70 | $72.44 | $85.11 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $151.36 Typical High $229.09 | Professional | None | $54.95 | $151.36 | $229.09 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | None | $54.95 | $54.95 | $57.54 |
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 $29.51 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $29.51 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $11.75 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $6.31 |
Where Arizona sits
Rates are fairly even across states for this service. 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· 19th of 51
$57.54
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.