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 $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
BCBS Arizona Setting Facility Modifier None Typical Low $8.71 Median $38.90 Typical High $58.88 | Facility | None | $8.71 | $38.90 | $58.88 |
BCBS Arizona Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $52.48 | Professional | None | $25.12 | $28.84 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $32.36 Typical High $131.83 | Facility | None | $14.45 | $32.36 | $131.83 |
Medica Setting Professional Modifier None Typical Low $11.48 Median $17.78 Typical High $158.49 | Professional | None | $11.48 | $17.78 | $158.49 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $16.22 | Facility | None | $12.88 | $12.88 | $16.22 |
United Setting Professional Modifier None Typical Low $11.48 Median $12.30 Typical High $18.62 | Professional | None | $11.48 | $12.30 | $18.62 |
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 $7.24 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.95 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Where Arizona sits
The same service costs 3.0 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· 31st of 51
$16.22
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.