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 $72.44 Median $72.44 Typical High $89.13 | Professional | None | $72.44 | $72.44 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS Arizona Setting Facility Modifier None Typical Low $39.81 Median $181.97 Typical High $275.42 | Facility | None | $39.81 | $181.97 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $245.47 | Professional | None | $117.49 | $134.90 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $181.97 Typical High $724.44 | Facility | None | $77.62 | $181.97 | $724.44 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $1,288.25 | Professional | None | $63.10 | $81.28 | $1,288.25 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $120.23 | Facility | None | $91.20 | $91.20 | $120.23 |
United Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $102.33 | Professional | None | $61.66 | $67.61 | $102.33 |
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 $36.31 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.24 |
Where Arizona sits
The same service costs 5.0 times more in Hawaii than in Delaware. 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· 39th of 51
$79.43
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.