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 Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $41.69 | Facility | None | $37.15 | $37.15 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $28.18 | Professional | None | $26.30 | $28.18 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
BCBS Arizona Setting Facility Modifier None Typical Low $23.44 Median $100.00 Typical High $162.18 | Facility | None | $23.44 | $100.00 | $162.18 |
BCBS Arizona Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $37.15 | Professional | None | $24.55 | $24.55 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $45.71 Typical High $48.98 | Facility | None | $32.36 | $45.71 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $28.84 Typical High $75.86 | Facility | None | $23.44 | $28.84 | $75.86 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $102.33 Typical High $102.33 | Professional | None | $23.99 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
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 $13.49 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $13.49 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.50 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.07 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.69 | $2.82 | $2.82 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | JW · Drug discarded | $25.70 | $25.70 | $25.70 |
Where Arizona sits
Rates are fairly even across states for this service. 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· 29th of 51
$25.70
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.