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 $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
BCBS Arizona Setting Facility Modifier None Typical Low $22.91 Median $102.33 Typical High $154.88 | Facility | None | $22.91 | $102.33 | $154.88 |
BCBS Arizona Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $138.04 | Professional | None | $66.07 | $75.86 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $85.11 Typical High $407.38 | Facility | None | $38.90 | $85.11 | $407.38 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $446.68 | Professional | None | $36.31 | $56.23 | $446.68 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $58.88 | Professional | None | $36.31 | $38.90 | $58.88 |
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 $19.50 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $3.89 |
Where Arizona sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 30th of 51
$58.88
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.