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 $83.18 Median $83.18 Typical High $109.65 | Facility | None | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $147.91 | Professional | None | $83.18 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $54.95 Typical High $56.23 | Professional | 52 · Reduced service | $41.69 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.60 Typical High $16.98 | Professional | 55 · Aftercare only | $12.59 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $11.22 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $151.36 | Professional | None | $123.03 | $138.04 | $151.36 |
BCBS Arizona Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $151.36 | Professional | None | $87.10 | $117.49 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $165.96 | Professional | None | $87.10 | $117.49 | $165.96 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $512.86 | Facility | None | $91.20 | $120.23 | $512.86 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $724.44 Typical High $954.99 | Professional | None | $125.89 | $724.44 | $954.99 |
United Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $158.49 | Professional | None | $89.13 | $120.23 | $158.49 |
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 $114.82 Median $128.82 Typical High $223.87 | Professional | 25 · Same-day visit | $114.82 | $128.82 | $223.87 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $100.00 Median $223.87 Typical High $223.87 | Professional | GC · Resident with teaching physician | $100.00 | $223.87 | $223.87 |
Where Arizona sits
The same service costs 2.7 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· 44th of 51
$126
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.