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 $15.49 Median $15.49 Typical High $19.05 | Professional | None | $15.49 | $15.49 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
BCBS Arizona Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $46.77 | Professional | None | $20.89 | $21.38 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $25.70 Typical High $158.49 | Facility | None | $15.49 | $25.70 | $158.49 |
Medica Setting Professional Modifier None Typical Low $10.47 Median $11.75 Typical High $363.08 | Professional | None | $10.47 | $11.75 | $363.08 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.96 Typical High $17.78 | Professional | None | $10.47 | $10.96 | $17.78 |
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 $7.76 Median $7.76 Typical High $7.94 | Professional | 52 · Reduced service | $7.76 | $7.76 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.16 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.16 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 54 · Surgery only | $11.48 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.40 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.58 |
Where Arizona sits
The same service costs 3.5 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
$15.49
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.