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 $19.50 Median $21.88 Typical High $33.11 | Facility | None | $19.50 | $21.88 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $22.39 | Professional | None | $16.22 | $17.78 | $22.39 |
BCBS Arizona Setting Facility Modifier None Typical Low $19.05 Median $57.54 Typical High $125.89 | Facility | None | $19.05 | $57.54 | $125.89 |
BCBS Arizona Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $93.33 | Professional | None | $13.18 | $13.18 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $30.20 | Facility | None | $19.95 | $28.18 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $32.36 Typical High $85.11 | Facility | None | $25.70 | $32.36 | $85.11 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | None | $13.80 | $13.80 | $15.14 |
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 $8.91 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $1.78 |
Ambetter Setting Professional Modifier JW · Drug discarded + JZ · No drug discarded + KP · First drug of several + KQ · Later drug of several Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | JW · Drug discarded + JZ · No drug discarded + KP · First drug of several + KQ · Later drug of several | $16.22 | $16.22 | $16.22 |
Where Arizona sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 5th of 51
$26.30
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.