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 $630.96 Median $1,819.70 Typical High $3,715.35 | Facility | None | $630.96 | $1,819.70 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,202.26 | Professional | None | $630.96 | $630.96 | $1,202.26 |
BCBS Arkansas Setting Facility Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $25,703.96 | Facility | None | $18,620.87 | $18,620.87 | $25,703.96 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,000.00 Typical High $3,715.35 | Facility | None | $562.34 | $1,000.00 | $3,715.35 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $4,265.80 Typical High $11,481.54 | Facility | None | $2,454.71 | $4,265.80 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,445.44 | $2,238.72 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $316.23 Typical High $562.34 | Professional | 52 · Reduced service | $316.23 | $316.23 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $229.09 | Professional | 53 · Discontinued | $125.89 | $125.89 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $169.82 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $112.20 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $112.20 |
Where Arkansas sits
The same service costs 18.2 times more in California 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· 9th of 51
$4,266
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.