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 $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
BCBS Arizona Setting Facility Modifier None Typical Low $173.78 Median $794.33 Typical High $1,202.26 | Facility | None | $173.78 | $794.33 | $1,202.26 |
BCBS Arizona Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $1,071.52 | Professional | None | $512.86 | $588.84 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $3,162.28 | Facility | None | $281.84 | $660.69 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $3,388.44 | Professional | None | $281.84 | $389.05 | $3,388.44 |
United Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $457.09 | Professional | None | $275.42 | $302.00 | $457.09 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Arizona sits
The same service costs 2.2 times more in Montana 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· 50th of 51
$316
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.