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 $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
BCBS Arizona Setting Facility Modifier None Typical Low $19.50 Median $87.10 Typical High $131.83 | Facility | None | $19.50 | $87.10 | $131.83 |
BCBS Arizona Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $117.49 | Professional | None | $56.23 | $64.57 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $72.44 Typical High $346.74 | Facility | None | $31.62 | $72.44 | $346.74 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $380.19 | Professional | None | $30.90 | $39.81 | $380.19 |
United Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $50.12 | Professional | None | $30.20 | $33.11 | $50.12 |
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 $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
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· 50th of 51
$33.11
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.