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 $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
BCBS Arizona Setting Facility Modifier None Typical Low $109.65 Median $489.78 Typical High $741.31 | Facility | None | $109.65 | $489.78 | $741.31 |
BCBS Arizona Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $660.69 | Professional | None | $316.23 | $363.08 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $407.38 Typical High $2,089.30 | Facility | None | $177.83 | $407.38 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $2,511.89 | Professional | None | $181.97 | $234.42 | $2,511.89 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Facility | None | $147.91 | $147.91 | $204.17 |
United Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $295.12 | Professional | None | $177.83 | $194.98 | $295.12 |
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 $81.28 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Where Arizona sits
The same service costs 2.9 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· 49th of 51
$195
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.