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 $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
BCBS Setting Facility Modifier None Typical Low $10.00 Median $44.67 Typical High $67.61 | Facility | None | $10.00 | $44.67 | $67.61 |
BCBS Setting Professional Modifier None Typical Low $28.84 Median $33.11 Typical High $60.26 | Professional | None | $28.84 | $33.11 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | None | $15.49 | $15.49 | $21.38 |
Medica Setting Facility Modifier None Typical Low $15.14 Median $37.15 Typical High $177.83 | Facility | None | $15.14 | $37.15 | $177.83 |
Medica Setting Professional Modifier None Typical Low $15.85 Median $20.42 Typical High $194.98 | Professional | None | $15.85 | $20.42 | $194.98 |
United Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $25.70 | Professional | None | $15.49 | $16.98 | $25.70 |
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 $7.41 Median $7.41 Typical High $7.41 | Professional | 52 · Reduced service | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $1.48 |
Where Arizona sits
The same service costs 3.1 times more in Montana than in Kansas. 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
$16.98
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.