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 $56.23 Median $56.23 Typical High $83.18 | Facility | None | $56.23 | $56.23 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $91.20 | Professional | None | $48.98 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $24.55 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $7.24 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.90 | $7.24 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | None | $95.50 | $100.00 | $100.00 |
BCBS Arizona Setting Professional Modifier None Typical Low $50.12 Median $72.44 Typical High $97.72 | Professional | None | $50.12 | $72.44 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $102.33 | Professional | None | $48.98 | $70.79 | $102.33 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $75.86 Typical High $309.03 | Facility | None | $48.98 | $75.86 | $309.03 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $426.58 Typical High $616.60 | Professional | None | $75.86 | $426.58 | $616.60 |
United Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $100.00 | Professional | None | $48.98 | $70.79 | $100.00 |
4 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 $75.86 Median $85.11 Typical High $95.50 | Professional | 25 · Same-day visit | $75.86 | $85.11 | $95.50 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $70.79 Median $93.33 Typical High $125.89 | Professional | EP · Child screening program | $70.79 | $93.33 | $125.89 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | GC · Resident with teaching physician | $100.00 | $100.00 | $100.00 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $85.11 Median $97.72 Typical High $204.17 | Professional | 25 · Same-day visit | $85.11 | $97.72 | $204.17 |
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
$77.62
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.