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 $34.67 Median $34.67 Typical High $47.86 | Professional | None | $34.67 | $34.67 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
BCBS Arizona Setting Facility Modifier None Typical Low $22.91 Median $104.71 Typical High $158.49 | Facility | None | $22.91 | $104.71 | $158.49 |
BCBS Arizona Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $138.04 | Professional | None | $67.61 | $75.86 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $87.10 Typical High $416.87 | Facility | None | $25.70 | $87.10 | $416.87 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $446.68 | Professional | None | $36.31 | $47.86 | $446.68 |
United Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $60.26 | Professional | None | $35.48 | $39.81 | $60.26 |
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 $17.38 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.47 |
Where Arizona sits
The same service costs 3.0 times more in Hawaii 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
$39.81
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.