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 $46.77 Median $53.70 Typical High $79.43 | Facility | None | $46.77 | $53.70 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $154.88 | Professional | None | $46.77 | $63.10 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $91.20 | Professional | None | $54.95 | $72.44 | $91.20 |
BCBS Arizona Setting Facility Modifier None Typical Low $95.50 Median $407.38 Typical High $616.60 | Facility | None | $95.50 | $407.38 | $616.60 |
BCBS Arizona Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $141.25 | Professional | None | $64.57 | $64.57 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $186.21 | Professional | None | $66.07 | $79.43 | $186.21 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $69.18 Typical High $177.83 | Facility | None | $63.10 | $69.18 | $177.83 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $616.60 | Professional | None | $89.13 | $177.83 | $616.60 |
United Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $158.49 | Professional | None | $83.18 | $95.50 | $158.49 |
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 $31.62 Median $31.62 Typical High $39.81 | Professional | 52 · Reduced service | $31.62 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $7.94 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $77.62 Median $91.20 Typical High $107.15 | Professional | 25 · Same-day visit | $77.62 | $91.20 | $107.15 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $66.07 Median $75.86 Typical High $75.86 | Professional | 57 · Decision for surgery | $66.07 | $75.86 | $75.86 |
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· 44th of 51
$85.11
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.