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 $87.10 Median $1,000.00 Typical High $2,041.74 | Facility | None | $87.10 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $177.83 | Professional | None | $87.10 | $128.82 | $177.83 |
BCBS Arkansas Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | None | $162.18 | $162.18 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $288.40 | Professional | None | $95.50 | $151.36 | $288.40 |
United Setting Facility Modifier None Typical Low $128.82 Median $436.52 Typical High $776.25 | Facility | None | $128.82 | $436.52 | $776.25 |
United Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $309.03 | Professional | None | $75.86 | $151.36 | $309.03 |
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 $43.65 Median $61.66 Typical High $89.13 | Professional | 52 · Reduced service | $43.65 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $24.55 Typical High $35.48 | Professional | 53 · Discontinued | $17.38 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $91.20 Typical High $131.83 | Professional | 54 · Surgery only | $66.07 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.20 Typical High $26.30 | Professional | 55 · Aftercare only | $13.18 | $18.20 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.30 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.71 | $12.30 | $17.78 |
Where Arkansas sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 20th of 51
$162
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.