How much rates vary
Facilitymedian $48 · 10th to 90th $26 to $178Professionalmedian $41 · 10th to 90th $23 to $117
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 $19.95 Median $32.36 Typical High $61.66 | Facility | None | $19.95 | $32.36 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $32.36 Typical High $46.77 | Professional | None | $19.95 | $32.36 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $75.86 | Professional | None | $40.74 | $54.95 | $75.86 |
BCBS Arizona Setting Professional Modifier None Typical Low $25.70 Median $37.15 Typical High $50.12 | Professional | None | $25.70 | $37.15 | $50.12 |
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 $25.70 Median $38.90 Typical High $54.95 | Professional | None | $25.70 | $38.90 | $54.95 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $47.86 Typical High $177.83 | Facility | None | $26.92 | $47.86 | $177.83 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $223.87 Typical High $354.81 | Professional | None | $38.02 | $223.87 | $354.81 |
United Setting Professional Modifier None Typical Low $21.88 Median $35.48 Typical High $53.70 | Professional | None | $21.88 | $35.48 | $53.70 |
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 $13.49 Median $14.79 Typical High $22.39 | Facility | 52 · Reduced service | $13.49 | $14.79 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $4.47 Typical High $6.61 | Facility | 55 · Aftercare only | $3.98 | $4.47 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.95 Typical High $4.47 | Facility | 56 · Pre-op care only | $2.69 | $2.95 | $4.47 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $26.92 Median $29.51 Typical High $44.67 | Facility | AF · Specialist physician | $26.92 | $29.51 | $44.67 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $19.95 Median $21.88 Typical High $33.11 | Facility | HO · Master's level | $19.95 | $21.88 | $33.11 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $22.91 Median $25.12 Typical High $38.02 | Facility | TD · Registered nurse | $22.91 | $25.12 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $17.78 Typical High $21.38 | Professional | 52 · Reduced service | $13.49 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.37 Typical High $6.46 | Professional | 55 · Aftercare only | $3.98 | $5.37 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.55 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.69 | $3.55 | $4.37 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $26.92 Median $34.67 Typical High $43.65 | Professional | AF · Specialist physician | $26.92 | $34.67 | $43.65 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $19.95 Median $32.36 Typical High $32.36 | Professional | HO · Master's level | $19.95 | $32.36 | $32.36 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $22.91 Median $36.31 Typical High $36.31 | Professional | TD · Registered nurse | $22.91 | $36.31 | $36.31 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 24 · Unrelated visit after surgery | $47.86 | $47.86 | $47.86 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $54.95 Typical High $66.07 | Professional | 25 · Same-day visit | $46.77 | $54.95 | $66.07 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $46.77 Median $56.23 Typical High $61.66 | Professional | 93 · Audio-only telehealth | $46.77 | $56.23 | $61.66 |
Ambetter Setting Professional Modifier AQ · Shortage area physician Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | AQ · Shortage area physician | $69.18 | $69.18 | $69.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $57.54 Median $57.54 Typical High $85.11 | Professional | GC · Resident with teaching physician | $57.54 | $57.54 | $85.11 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $26.30 Median $44.67 Typical High $114.82 | Professional | 25 · Same-day visit | $26.30 | $44.67 | $114.82 |
Where Arizona sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 35th of 51
$40.74
AK $77.62NJ $32.36
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.