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 $204.17 Median $204.17 Typical High $208.93 | Professional | None | $204.17 | $204.17 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS Arizona Setting Facility Modifier None Typical Low $120.23 Median $549.54 Typical High $831.76 | Facility | None | $120.23 | $549.54 | $831.76 |
BCBS Arizona Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $741.31 | Professional | None | $354.81 | $407.38 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $457.09 Typical High $1,995.26 | Facility | None | $204.17 | $457.09 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $2,187.76 | Professional | None | $173.78 | $269.15 | $2,187.76 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $281.84 | Professional | None | $173.78 | $190.55 | $281.84 |
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 $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Where Arizona sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 40th of 51
$251
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.