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 $9.12 Median $9.12 Typical High $14.45 | Professional | None | $9.12 | $9.12 | $14.45 |
Ambetter Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
BCBS Arizona Setting Professional Modifier None Typical Low $12.30 Median $12.59 Typical High $28.18 | Professional | None | $12.30 | $12.59 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Medica Setting Facility Modifier None Typical Low $9.12 Median $15.14 Typical High $125.89 | Facility | None | $9.12 | $15.14 | $125.89 |
Medica Setting Professional Modifier None Typical Low $6.17 Median $6.92 Typical High $295.12 | Professional | None | $6.17 | $6.92 | $295.12 |
United Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $10.47 | Professional | None | $6.17 | $6.46 | $10.47 |
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 $4.57 Median $4.57 Typical High $4.68 | Professional | 52 · Reduced service | $4.57 | $4.57 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.82 Typical High $1.86 | Professional | 53 · Discontinued | $1.82 | $1.82 | $1.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 54 · Surgery only | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $1.38 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $0.93 |
Where Arizona sits
The same service costs 4.5 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
$9.12
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.