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 $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
BCBS Arizona Setting Facility Modifier None Typical Low $37.15 Median $165.96 Typical High $251.19 | Facility | None | $37.15 | $165.96 | $251.19 |
BCBS Arizona Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $223.87 | Professional | None | $107.15 | $123.03 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $138.04 Typical High $707.95 | Facility | None | $60.26 | $138.04 | $707.95 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $831.76 | Professional | None | $64.57 | $89.13 | $831.76 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $104.71 | Professional | None | $63.10 | $69.18 | $104.71 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
Where Arizona sits
The same service costs 2.5 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
$69.18
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.