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 $16.22 Median $16.22 Typical High $19.50 | Professional | None | $16.22 | $16.22 | $19.50 |
BCBS Arizona Setting Facility Modifier None Typical Low $10.72 Median $48.98 Typical High $74.13 | Facility | None | $10.72 | $48.98 | $74.13 |
BCBS Arizona Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $64.57 | Professional | None | $30.90 | $35.48 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $40.74 Typical High $190.55 | Facility | None | $17.38 | $40.74 | $190.55 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $208.93 | Professional | None | $16.98 | $23.44 | $208.93 |
United Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $27.54 | Professional | None | $16.60 | $18.62 | $27.54 |
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 $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Where Arizona sits
The same service costs 2.6 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· 48th of 51
$18.62
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.