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 $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Arizona Setting Facility Modifier None Typical Low $28.18 Median $120.23 Typical High $181.97 | Facility | None | $28.18 | $120.23 | $181.97 |
BCBS Arizona Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $39.81 | Professional | None | $26.30 | $26.30 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $51.29 Typical High $120.23 | Facility | None | $46.77 | $51.29 | $120.23 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $371.54 Typical High $371.54 | Professional | None | $60.26 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $23.44 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $4.68 |
Where Arizona sits
The same service costs 4.6 times more in New York than in North 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· 36th of 51
$60.26
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.