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 $102.33 Median $1,000.00 Typical High $2,041.74 | Facility | None | $102.33 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $295.12 | Professional | None | $81.28 | $208.93 | $295.12 |
BCBS Arkansas Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | None | $316.23 | $316.23 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $446.68 | Professional | None | $97.72 | $158.49 | $446.68 |
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 $81.28 Median $234.42 Typical High $562.34 | Professional | None | $81.28 | $234.42 | $562.34 |
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 $48.98 Median $79.43 Typical High $144.54 | Professional | 52 · Reduced service | $48.98 | $79.43 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $31.62 Typical High $57.54 | Professional | 53 · Discontinued | $19.50 | $31.62 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $117.49 Typical High $213.80 | Professional | 54 · Surgery only | $74.13 | $117.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $23.44 Typical High $42.66 | Professional | 55 · Aftercare only | $14.79 | $23.44 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $15.85 Typical High $28.84 | Professional | 56 · Pre-op care only | $9.77 | $15.85 | $28.84 |
Where Arkansas sits
The same service costs 4.2 times more in Washington 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· 8th of 51
$316
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.