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 $72.44 Median $72.44 Typical High $97.72 | Facility | None | $72.44 | $72.44 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $114.82 | Professional | None | $63.10 | $87.10 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $120.23 | Professional | None | $95.50 | $107.15 | $120.23 |
BCBS Arizona Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $117.49 | Professional | None | $64.57 | $91.20 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $125.89 | Professional | None | $63.10 | $87.10 | $125.89 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $389.05 | Facility | None | $66.07 | $95.50 | $389.05 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $537.03 Typical High $724.44 | Professional | None | $91.20 | $537.03 | $724.44 |
United Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $123.03 | Professional | None | $66.07 | $89.13 | $123.03 |
7 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 $31.62 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $31.62 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $9.33 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.31 | $8.71 | $8.71 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 24 · Unrelated visit after surgery | $147.91 | $147.91 | $147.91 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $102.33 Typical High $120.23 | Professional | 25 · Same-day visit | $89.13 | $102.33 | $120.23 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | GC · Resident with teaching physician | $173.78 | $173.78 | $213.80 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $117.49 Typical High $213.80 | Professional | 25 · Same-day visit | $100.00 | $117.49 | $213.80 |
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
$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.