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 $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
BCBS Arizona Setting Facility Modifier None Typical Low $20.42 Median $91.20 Typical High $138.04 | Facility | None | $20.42 | $91.20 | $138.04 |
BCBS Arizona Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $123.03 | Professional | None | $58.88 | $67.61 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $75.86 Typical High $363.08 | Facility | None | $33.11 | $75.86 | $363.08 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $389.05 | Professional | None | $32.36 | $44.67 | $389.05 |
United Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $52.48 | Professional | None | $31.62 | $34.67 | $52.48 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.02 |
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
$35.48
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.