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 $2.63 Median $977.24 Typical High $2,041.74 | Facility | None | $2.63 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $5.37 Typical High $9.55 | Professional | None | $2.24 | $5.37 | $9.55 |
Ambetter Setting Professional Modifier None Typical Low $7.76 Median $8.71 Typical High $9.77 | Professional | None | $7.76 | $8.71 | $9.77 |
BCBS Arkansas Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $8.71 | Professional | None | $6.61 | $6.61 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $645.65 | Facility | None | $50.12 | $100.00 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $4.37 Typical High $9.33 | Professional | None | $2.14 | $4.37 | $9.33 |
Qualchoice Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $11.22 | Professional | None | $8.51 | $9.55 | $11.22 |
United Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $707.95 | Facility | None | $75.86 | $128.82 | $707.95 |
United Setting Professional Modifier None Typical Low $2.04 Median $5.50 Typical High $11.48 | Professional | None | $2.04 | $5.50 | $11.48 |
6 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 $1.32 Median $2.63 Typical High $2.75 | Professional | 52 · Reduced service | $1.32 | $2.63 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $1.05 Typical High $1.12 | Professional | 53 · Discontinued | $0.52 | $1.05 | $1.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $3.89 Typical High $4.17 | Professional | 54 · Surgery only | $1.95 | $3.89 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.78 Typical High $0.83 | Professional | 55 · Aftercare only | $0.39 | $0.78 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.52 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.26 | $0.52 | $0.55 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $5.01 Median $7.76 Typical High $7.76 | Professional | 59 · Distinct service | $5.01 | $7.76 | $7.76 |
Where Arkansas sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 15th of 51
$7.41
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.