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 $61.66 Median $61.66 Typical High $91.20 | Facility | None | $61.66 | $61.66 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $102.33 | Professional | None | $53.70 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $26.92 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $7.94 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.37 | $7.94 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $125.89 | Professional | None | $83.18 | $89.13 | $125.89 |
BCBS Arizona Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $109.65 | Professional | None | $54.95 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $114.82 | Professional | None | $54.95 | $83.18 | $114.82 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $89.13 Typical High $346.74 | Facility | None | $57.54 | $89.13 | $346.74 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $467.74 Typical High $691.83 | Professional | None | $93.33 | $467.74 | $691.83 |
United Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $112.20 | Professional | None | $57.54 | $83.18 | $112.20 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $83.18 Median $89.13 Typical High $95.50 | Professional | 25 · Same-day visit | $83.18 | $89.13 | $95.50 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $89.13 Median $100.00 Typical High $104.71 | Professional | EP · Child screening program | $89.13 | $100.00 | $104.71 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | Q6 · Substitute physician, paid per time | $117.49 | $117.49 | $117.49 |
Where Arizona sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 42nd of 51
$87.10
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.