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 $34.67 Median $1,000.00 Typical High $2,041.74 | Facility | None | $34.67 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $47.86 Typical High $67.61 | Professional | None | $30.90 | $47.86 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $85.11 | Professional | None | $57.54 | $72.44 | $85.11 |
BCBS Arkansas Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $251.19 | Facility | None | $181.97 | $181.97 | $251.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $75.86 | Professional | None | $30.20 | $39.81 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $512.86 | Facility | None | $50.12 | $100.00 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $48.98 Typical High $75.86 | Professional | None | $28.84 | $48.98 | $75.86 |
Qualchoice Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $97.72 | Professional | None | $79.43 | $83.18 | $97.72 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $83.18 | Professional | None | $28.18 | $48.98 | $83.18 |
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 $17.38 Median $21.38 Typical High $30.20 | Professional | 52 · Reduced service | $17.38 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.51 Typical High $12.02 | Professional | 53 · Discontinued | $6.92 | $8.51 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $32.36 Typical High $44.67 | Professional | 54 · Surgery only | $25.70 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.46 Typical High $8.91 | Professional | 55 · Aftercare only | $5.25 | $6.46 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.27 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.47 | $4.27 | $6.03 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 59 · Distinct service | $69.18 | $81.28 | $81.28 |
Qualchoice Setting Professional Modifier 59 · Distinct service Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 59 · Distinct service | $79.43 | $93.33 | $93.33 |
Where Arkansas sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 10th of 51
$69.18
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.