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 $5.01 Median $5.01 Typical High $6.61 | Professional | None | $5.01 | $5.01 | $6.61 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
BCBS Arizona Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $15.49 | Professional | None | $6.92 | $6.92 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Medica Setting Facility Modifier None Typical Low $5.01 Median $8.51 Typical High $89.13 | Facility | None | $5.01 | $8.51 | $89.13 |
Medica Setting Professional Modifier None Typical Low $3.39 Median $3.80 Typical High $138.04 | Professional | None | $3.39 | $3.80 | $138.04 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $5.75 | Professional | None | $3.39 | $3.55 | $5.75 |
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 $2.51 Median $2.51 Typical High $2.57 | Professional | 52 · Reduced service | $2.51 | $2.51 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.00 Typical High $1.02 | Professional | 53 · Discontinued | $1.00 | $1.00 | $1.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.80 Median $3.80 Typical High $3.89 | Professional | 54 · Surgery only | $3.80 | $3.80 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.78 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.51 |
Where Arizona sits
The same service costs 4.1 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
$5.01
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.