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 $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $5.89 Median $6.03 Typical High $13.18 | Professional | None | $5.89 | $6.03 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Medica Setting Facility Modifier None Typical Low $4.37 Median $7.24 Typical High $89.13 | Facility | None | $4.37 | $7.24 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $3.31 Typical High $63.10 | Professional | None | $2.95 | $3.31 | $63.10 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.09 Typical High $5.01 | Professional | None | $2.95 | $3.09 | $5.01 |
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 $2.19 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 54 · Surgery only | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Where Arizona sits
The same service costs 2.7 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· 30th of 51
$4.37
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.