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 $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
BCBS Arizona Setting Facility Modifier None Typical Low $128.82 Median $588.84 Typical High $891.25 | Facility | None | $128.82 | $588.84 | $891.25 |
BCBS Arizona Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $776.25 | Professional | None | $380.19 | $436.52 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $489.78 Typical High $2,511.89 | Facility | None | $218.78 | $489.78 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $3,235.94 | Professional | None | $223.87 | $346.74 | $3,235.94 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $245.47 | Facility | None | $138.04 | $138.04 | $245.47 |
United Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $371.54 | Professional | None | $223.87 | $245.47 | $371.54 |
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 $109.65 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $21.88 |
Where Arizona sits
The same service costs 2.7 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· 31st of 51
$309
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.