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 $77.62 Median $77.62 Typical High $120.23 | Professional | None | $77.62 | $77.62 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $177.83 | Professional | None | $169.82 | $173.78 | $177.83 |
BCBS Arizona Setting Facility Modifier None Typical Low $42.66 Median $194.98 Typical High $295.12 | Facility | None | $42.66 | $194.98 | $295.12 |
BCBS Arizona Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $263.03 | Professional | None | $125.89 | $144.54 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $194.98 Typical High $933.25 | Facility | None | $83.18 | $194.98 | $933.25 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $1,000.00 | Professional | None | $83.18 | $107.15 | $1,000.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $134.90 | Professional | None | $81.28 | $89.13 | $134.90 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where Arizona sits
The same service costs 2.3 times more in Hawaii 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· 43rd of 51
$107
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.