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 $81.28 Median $1,174.90 Typical High $2,454.71 | Facility | None | $81.28 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $165.96 | Professional | None | $74.13 | $125.89 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
BCBS Arkansas Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Facility | None | $380.19 | $380.19 | $524.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $199.53 | Professional | None | $70.79 | $95.50 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $512.86 | Facility | None | $50.12 | $107.15 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $208.93 | Professional | None | $69.18 | $131.83 | $208.93 |
Qualchoice Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $741.31 | Facility | None | $79.43 | $131.83 | $741.31 |
United Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $208.93 | Professional | None | $67.61 | $117.49 | $208.93 |
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 $40.74 Median $51.29 Typical High $83.18 | Professional | 52 · Reduced service | $40.74 | $51.29 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $33.11 | Professional | 53 · Discontinued | $16.60 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $77.62 Typical High $125.89 | Professional | 54 · Surgery only | $61.66 | $77.62 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.49 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $15.49 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.23 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.13 | $10.23 | $16.60 |
Where Arkansas sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 17th of 51
$151
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.