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 $3.24 Median $3.24 Typical High $3.98 | Professional | None | $3.24 | $3.24 | $3.98 |
BCBS Arizona Setting Professional Modifier None Typical Low $4.37 Median $4.47 Typical High $10.00 | Professional | None | $4.37 | $4.47 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $5.37 Typical High $89.13 | Facility | None | $3.24 | $5.37 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $2.45 Typical High $83.18 | Professional | None | $2.19 | $2.45 | $83.18 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.29 Typical High $3.72 | Professional | None | $2.19 | $2.29 | $3.72 |
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 $1.62 Median $1.62 Typical High $1.66 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.66 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.40 Median $2.40 Typical High $2.45 | Professional | 54 · Surgery only | $2.40 | $2.40 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.48 Typical High $0.49 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.33 |
Where Arizona sits
The same service costs 3.8 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
$3.24
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.