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 $13.18 Median $13.18 Typical High $16.98 | Professional | None | $13.18 | $13.18 | $16.98 |
BCBS Setting Facility Modifier None Typical Low $12.59 Median $56.23 Typical High $85.11 | Facility | None | $12.59 | $56.23 | $85.11 |
BCBS Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $75.86 | Professional | None | $36.31 | $41.69 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $67.61 Typical High $186.21 | Facility | None | $14.45 | $67.61 | $186.21 |
Medica Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $245.47 | Professional | None | $21.38 | $25.12 | $245.47 |
United Setting Professional Modifier None Typical Low $20.89 Median $22.39 Typical High $41.69 | Professional | None | $20.89 | $22.39 | $41.69 |
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 $6.61 Median $6.61 Typical High $8.13 | Professional | 52 · Reduced service | $6.61 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $3.24 | Professional | 53 · Discontinued | $2.63 | $2.63 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.45 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.62 |
Where Arizona sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 48th of 51
$22.39
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.