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 $28.18 Median $32.36 Typical High $41.69 | Facility | None | $28.18 | $32.36 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $79.43 | Professional | None | $28.18 | $37.15 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $56.23 | Professional | None | $30.20 | $44.67 | $56.23 |
BCBS Arizona Setting Facility Modifier None Typical Low $38.90 Median $169.82 Typical High $251.19 | Facility | None | $38.90 | $169.82 | $251.19 |
BCBS Arizona Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $83.18 | Professional | None | $38.02 | $38.02 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $83.18 | Professional | None | $35.48 | $39.81 | $83.18 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $40.74 Typical High $107.15 | Facility | None | $37.15 | $40.74 | $107.15 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $74.13 Typical High $346.74 | Professional | None | $35.48 | $74.13 | $346.74 |
United Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $81.28 | Professional | None | $34.67 | $38.02 | $81.28 |
6 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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 24 · Unrelated visit after surgery | $38.90 | $38.90 | $38.90 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 25 · Same-day visit | $63.10 | $63.10 | $63.10 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $34.67 Median $34.67 Typical High $45.71 | Professional | FS · Shared visit | $34.67 | $34.67 | $45.71 |
Where Arizona sits
The same service costs 2.7 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· 50th of 51
$38.02
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.