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 Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $107.15 | Professional | None | $57.54 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $28.84 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $8.51 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.75 | $8.51 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | None | $123.03 | $128.82 | $128.82 |
BCBS Arizona Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $114.82 | Professional | None | $58.88 | $83.18 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $123.03 | Professional | None | $63.10 | $91.20 | $123.03 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $380.19 | Facility | None | $63.10 | $93.33 | $380.19 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $501.19 Typical High $707.95 | Professional | None | $100.00 | $501.19 | $707.95 |
United Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $117.49 | Professional | None | $64.57 | $89.13 | $117.49 |
2 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 $87.10 Median $97.72 Typical High $117.49 | Professional | 25 · Same-day visit | $87.10 | $97.72 | $117.49 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | EP · Child screening program | $97.72 | $97.72 | $97.72 |
Where Arizona sits
The same service costs 2.8 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· 39th of 51
$95.50
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.