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 $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS Arizona Setting Facility Modifier None Typical Low $69.18 Median $309.03 Typical High $467.74 | Facility | None | $69.18 | $309.03 | $467.74 |
BCBS Arizona Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $416.87 | Professional | None | $199.53 | $229.09 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $257.04 Typical High $1,071.52 | Facility | None | $112.20 | $257.04 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $1,258.93 | Professional | None | $93.33 | $120.23 | $1,258.93 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $128.82 | Facility | None | $63.10 | $63.10 | $128.82 |
United Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $151.36 | Professional | None | $91.20 | $100.00 | $151.36 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where Arizona sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 47th of 51
$105
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.