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 $4.79 Median $4.79 Typical High $6.46 | Professional | None | $4.79 | $4.79 | $6.46 |
BCBS Arizona Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $14.79 | Professional | None | $6.61 | $6.61 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Medica Setting Facility Modifier None Typical Low $4.79 Median $8.13 Typical High $89.13 | Facility | None | $4.79 | $8.13 | $89.13 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $3.72 Typical High $107.15 | Professional | None | $3.24 | $3.72 | $107.15 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $5.62 | Professional | None | $3.24 | $3.47 | $5.62 |
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 $2.45 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $1.00 | Professional | 53 · Discontinued | $0.98 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 54 · Surgery only | $3.63 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.74 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.49 |
Where Arizona sits
The same service costs 3.2 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· 33rd of 51
$4.79
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.