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 $812.83 Median $1,819.70 Typical High $5,128.61 | Facility | None | $812.83 | $1,819.70 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $741.31 | Professional | None | $302.00 | $302.00 | $741.31 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,995.26 | $3,801.89 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $2,344.23 | Facility | None | $588.84 | $1,949.84 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $5,011.87 | Facility | None | $1,096.48 | $1,513.56 | $5,011.87 |
United Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,047.13 | Professional | None | $457.09 | $691.83 | $1,047.13 |
5 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 $151.36 Median $151.36 Typical High $269.15 | Professional | 52 · Reduced service | $151.36 | $151.36 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $107.15 | Professional | 53 · Discontinued | $60.26 | $60.26 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $407.38 | Professional | 54 · Surgery only | $229.09 | $229.09 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $81.28 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $53.70 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $53.70 |
Where Arkansas sits
The same service costs 10.2 times more in Texas than in New York. 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.
Arkansas· 12th of 51
$1,995
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.