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 $60.26 Median $83.18 Typical High $112.20 | Professional | None | $60.26 | $83.18 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $117.49 | Professional | None | $93.33 | $112.20 | $117.49 |
BCBS Arizona Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $114.82 | Professional | None | $63.10 | $87.10 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $123.03 | Professional | None | $63.10 | $85.11 | $123.03 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $91.20 Typical High $371.54 | Facility | None | $66.07 | $91.20 | $371.54 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $524.81 Typical High $724.44 | Professional | None | $91.20 | $524.81 | $724.44 |
United Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $117.49 | Professional | None | $66.07 | $87.10 | $117.49 |
6 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 $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $30.20 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $8.32 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $87.10 Median $100.00 Typical High $112.20 | Professional | 25 · Same-day visit | $87.10 | $100.00 | $112.20 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | EP · Child screening program | $81.28 | $81.28 | $81.28 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $109.65 Typical High $194.98 | Professional | 25 · Same-day visit | $97.72 | $109.65 | $194.98 |
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· 42nd of 51
$93.33
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.