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 $93.33 Median $794.33 Typical High $2,041.74 | Facility | None | $93.33 | $794.33 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $213.80 | Professional | None | $75.86 | $169.82 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $269.15 | Professional | None | $93.33 | $93.33 | $269.15 |
BCBS Arkansas Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | None | $204.17 | $204.17 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $302.00 | Professional | None | $89.13 | $147.91 | $302.00 |
Qualchoice Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $74.13 Median $162.18 Typical High $380.19 | Professional | None | $74.13 | $162.18 | $380.19 |
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 $46.77 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $46.77 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $27.54 Typical High $38.02 | Professional | 53 · Discontinued | $18.62 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $102.33 Typical High $141.25 | Professional | 54 · Surgery only | $69.18 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $13.80 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.80 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.33 | $13.80 | $19.05 |
Where Arkansas sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 14th of 51
$204
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.