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 $147.91 Median $147.91 Typical High $223.87 | Professional | None | $147.91 | $147.91 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | None | $281.84 | $323.59 | $323.59 |
BCBS Arizona Setting Facility Modifier None Typical Low $81.28 Median $371.54 Typical High $562.34 | Facility | None | $81.28 | $371.54 | $562.34 |
BCBS Arizona Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $501.19 | Professional | None | $239.88 | $275.42 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $371.54 Typical High $1,778.28 | Facility | None | $158.49 | $371.54 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $1,905.46 | Professional | None | $154.88 | $213.80 | $1,905.46 |
United Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $251.19 | Professional | None | $151.36 | $169.82 | $251.19 |
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 $74.13 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $14.79 |
Where Arizona sits
The same service costs 2.4 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· 37th of 51
$200
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.