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 $30.90 Median $30.90 Typical High $38.90 | Professional | None | $30.90 | $30.90 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $79.43 | Professional | None | $32.36 | $39.81 | $79.43 |
BCBS Arizona Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $95.50 | Professional | None | $41.69 | $42.66 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $51.29 Typical High $316.23 | Facility | None | $30.90 | $51.29 | $316.23 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $724.44 | Professional | None | $20.89 | $23.44 | $724.44 |
United Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $35.48 | Professional | None | $20.89 | $21.88 | $35.48 |
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 $15.49 Median $15.49 Typical High $15.85 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.31 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 54 · Surgery only | $22.91 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.16 |
Where Arizona sits
The same service costs 2.6 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· 35th of 51
$30.90
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.