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 $1,698.24 Typical High $2,511.89 | Facility | None | $81.28 | $1,698.24 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | None | $67.61 | $81.28 | $81.28 |
BCBS Arkansas Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $870.96 | Facility | None | $331.13 | $645.65 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $380.19 Typical High $478.63 | Facility | None | $100.00 | $380.19 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $131.83 | Professional | None | $51.29 | $67.61 | $131.83 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $776.25 | Facility | None | $79.43 | $131.83 | $776.25 |
United Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $138.04 | Professional | None | $63.10 | $77.62 | $138.04 |
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 $33.88 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $33.88 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $13.80 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | 54 · Surgery only | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $10.23 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.76 | $8.13 | $8.13 |
Where Arkansas sits
The same service costs 5.5 times more in Arkansas 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· 1st of 51
$331
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.