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 $2.51 Median $2.51 Typical High $2.69 | Professional | None | $2.51 | $2.51 | $2.69 |
BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $7.76 | Professional | None | $3.47 | $3.47 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Medica Setting Facility Modifier None Typical Low $2.51 Median $4.27 Typical High $89.13 | Facility | None | $2.51 | $4.27 | $89.13 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $1.91 Typical High $69.18 | Professional | None | $1.70 | $1.91 | $69.18 |
United Setting Professional Modifier None Typical Low $1.70 Median $1.78 Typical High $2.88 | Professional | None | $1.70 | $1.78 | $2.88 |
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 $1.26 Median $1.26 Typical High $1.32 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.51 Median $0.51 Typical High $0.52 | Professional | 53 · Discontinued | $0.51 | $0.51 | $0.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.91 Median $1.91 Typical High $1.95 | Professional | 54 · Surgery only | $1.91 | $1.91 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $0.39 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.26 |
Where Arizona sits
The same service costs 4.0 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
$2.51
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.