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Arizona rates for HCPCS G2025

Payment for a telehealth distant site service furnished by a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.25 / $93.25 / $94.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.03 / $93.25 / $102.68
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.57 / $83.57 / $83.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.62 / $73.62 / $354.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.39 / $81.68 / $94.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.16 / $109.16 / $109.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.90 / $86.90 / $86.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.23 / $102.58 / $189.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.59 / $96.90 / $599.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.05 / $92.03 / $178.51