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 Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $19.05 | Professional | None | $15.85 | $15.85 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
BCBS Arizona Setting Facility Modifier None Typical Low $8.91 Median $39.81 Typical High $60.26 | Facility | None | $8.91 | $39.81 | $60.26 |
BCBS Arizona Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $53.70 | Professional | None | $25.70 | $29.51 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Medica Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $162.18 | Facility | None | $16.98 | $39.81 | $162.18 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $17.78 Typical High $245.47 | Professional | None | $13.80 | $17.78 | $245.47 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Facility | None | $19.95 | $19.95 | $28.18 |
United Setting Professional Modifier None Typical Low $13.49 Median $14.79 Typical High $22.39 | Professional | None | $13.49 | $14.79 | $22.39 |
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 $7.94 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.58 |
Where Arizona sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 46th of 51
$16.22
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.