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 $21.88 Median $21.88 Typical High $60.26 | Professional | None | $21.88 | $21.88 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
BCBS Arizona Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $67.61 | Professional | None | $29.51 | $30.20 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $36.31 Typical High $199.53 | Facility | None | $21.88 | $36.31 | $199.53 |
Medica Setting Professional Modifier None Typical Low $14.79 Median $16.60 Typical High $457.09 | Professional | None | $14.79 | $16.60 | $457.09 |
United Setting Professional Modifier None Typical Low $14.79 Median $15.49 Typical High $25.12 | Professional | None | $14.79 | $15.49 | $25.12 |
5 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 $10.96 Median $10.96 Typical High $11.22 | Professional | 52 · Reduced service | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $16.60 Typical High $16.98 | Professional | 54 · Surgery only | $16.60 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.39 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.24 |
Where Arizona sits
The same service costs 3.1 times more in Rhode Island than in New York. 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· 35th of 51
$21.88
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.