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 $44.67 Median $52.48 Typical High $61.66 | Facility | None | $44.67 | $52.48 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $107.15 | Professional | None | $44.67 | $60.26 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $83.18 | Professional | None | $54.95 | $69.18 | $83.18 |
BCBS Arizona Setting Facility Modifier None Typical Low $70.79 Median $302.00 Typical High $457.09 | Facility | None | $70.79 | $302.00 | $457.09 |
BCBS Arizona Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $144.54 | Professional | None | $64.57 | $64.57 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $147.91 | Professional | None | $63.10 | $69.18 | $147.91 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $66.07 Typical High $173.78 | Facility | None | $60.26 | $66.07 | $173.78 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $467.74 | Professional | None | $64.57 | $125.89 | $467.74 |
United Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $131.83 | Professional | None | $63.10 | $69.18 | $131.83 |
9 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 $30.20 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 24 · Unrelated visit after surgery | $69.18 | $69.18 | $69.18 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $54.95 Median $66.07 Typical High $100.00 | Professional | 25 · Same-day visit | $54.95 | $66.07 | $100.00 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 57 · Decision for surgery | $69.18 | $69.18 | $72.44 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $67.61 Median $89.13 Typical High $89.13 | Professional | FS · Shared visit | $67.61 | $89.13 | $89.13 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $89.13 Typical High $123.03 | Professional | GC · Resident with teaching physician | $72.44 | $89.13 | $123.03 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | JZ · No drug discarded | $69.18 | $69.18 | $69.18 |
Where Arizona sits
The same service costs 2.4 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· 48th of 51
$67.61
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.