How much rates vary
Facilitymedian $129 · 10th to 90th $95 to $562Professionalmedian $129 · 10th to 90th $87 to $363
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 $87.10 Median $109.65 Typical High $269.15 | Facility | None | $87.10 | $109.65 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $158.49 | Professional | None | $75.86 | $102.33 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $223.87 | Professional | None | $97.72 | $154.88 | $223.87 |
BCBS Arizona Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $151.36 | Professional | None | $97.72 | $123.03 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $234.42 | Facility | None | $95.50 | $109.65 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $186.21 | Professional | None | $107.15 | $131.83 | $186.21 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $602.56 | Facility | None | $102.33 | $141.25 | $602.56 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $831.76 Typical High $1,047.13 | Professional | None | $141.25 | $831.76 | $1,047.13 |
United Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $173.78 | Professional | None | $107.15 | $138.04 | $173.78 |
18 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 Facility Modifier 52 · Reduced service Typical Low $51.29 Median $56.23 Typical High $66.07 | Facility | 52 · Reduced service | $51.29 | $56.23 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $19.95 | Facility | 55 · Aftercare only | $15.14 | $16.60 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $13.18 | Facility | 56 · Pre-op care only | $10.23 | $11.22 | $13.18 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $102.33 Median $112.20 Typical High $131.83 | Facility | AF · Specialist physician | $102.33 | $112.20 | $131.83 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $75.86 Median $83.18 Typical High $100.00 | Facility | HO · Master's level | $75.86 | $83.18 | $100.00 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $87.10 Median $95.50 Typical High $112.20 | Facility | TD · Registered nurse | $87.10 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $51.29 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $12.88 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $102.33 Median $128.82 Typical High $162.18 | Professional | AF · Specialist physician | $102.33 | $128.82 | $162.18 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $75.86 Median $95.50 Typical High $120.23 | Professional | HO · Master's level | $75.86 | $95.50 | $120.23 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | TD · Registered nurse | $87.10 | $109.65 | $134.90 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $131.83 Median $165.96 Typical High $223.87 | Professional | 25 · Same-day visit | $131.83 | $165.96 | $223.87 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | 57 · Decision for surgery | $114.82 | $114.82 | $147.91 |
Ambetter Setting Professional Modifier AQ · Shortage area physician Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | AQ · Shortage area physician | $165.96 | $165.96 | $208.93 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $158.49 Median $173.78 Typical High $251.19 | Professional | GC · Resident with teaching physician | $158.49 | $173.78 | $251.19 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | Q6 · Substitute physician, paid per time | $173.78 | $173.78 | $173.78 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $128.82 Median $158.49 Typical High $371.54 | Professional | 25 · Same-day visit | $128.82 | $158.49 | $371.54 |
Where Arizona sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 46th of 51
$129
AK $263AL $115
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.