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 $14.13 Median $14.13 Typical High $15.49 | Professional | None | $14.13 | $14.13 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $14.45 Median $17.78 Typical High $18.20 | Professional | None | $14.45 | $17.78 | $18.20 |
BCBS Arizona Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $42.66 | Professional | None | $19.05 | $19.05 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $23.44 Typical High $117.49 | Facility | None | $14.13 | $23.44 | $117.49 |
Medica Setting Professional Modifier None Typical Low $9.33 Median $10.47 Typical High $269.15 | Professional | None | $9.33 | $10.47 | $269.15 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.77 Typical High $15.85 | Professional | None | $9.33 | $9.77 | $15.85 |
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 $7.08 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 54 · Surgery only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.41 |
Where Arizona sits
The same service costs 2.9 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
$14.13
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.