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 $28.18 Median $28.18 Typical High $28.84 | Professional | None | $28.18 | $28.18 | $28.84 |
BCBS Arizona Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $87.10 | Professional | None | $38.90 | $38.90 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $46.77 Typical High $263.03 | Facility | None | $28.18 | $46.77 | $263.03 |
Medica Setting Professional Modifier None Typical Low $19.05 Median $21.38 Typical High $616.60 | Professional | None | $19.05 | $21.38 | $616.60 |
United Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $32.36 | Professional | None | $19.05 | $19.95 | $32.36 |
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 $14.13 Median $14.13 Typical High $14.45 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 54 · Surgery only | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.88 |
Where Arizona sits
The same service costs 3.2 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· 31st of 51
$28.18
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.