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 $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
BCBS Arizona Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $36.31 | Professional | None | $16.22 | $16.22 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $19.50 Typical High $91.20 | Facility | None | $11.75 | $19.50 | $91.20 |
Medica Setting Professional Modifier None Typical Low $7.94 Median $8.91 Typical High $158.49 | Professional | None | $7.94 | $8.91 | $158.49 |
United Setting Professional Modifier None Typical Low $7.94 Median $8.32 Typical High $13.49 | Professional | None | $7.94 | $8.32 | $13.49 |
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 $5.89 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 54 · Surgery only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.17 |
Where Arizona sits
The same service costs 2.8 times more in Hawaii 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· 32nd of 51
$11.75
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.