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 $69.18 Median $977.24 Typical High $2,041.74 | Facility | None | $69.18 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $263.03 Typical High $371.54 | Professional | None | $51.29 | $263.03 | $371.54 |
BCBS Arkansas Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | None | $245.47 | $245.47 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $177.83 Typical High $512.86 | Professional | None | $57.54 | $177.83 | $512.86 |
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 $46.77 Median $263.03 Typical High $537.03 | Professional | None | $46.77 | $263.03 | $537.03 |
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 $29.51 Median $52.48 Typical High $186.21 | Professional | 52 · Reduced service | $29.51 | $52.48 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $21.38 Typical High $74.13 | Professional | 53 · Discontinued | $11.75 | $21.38 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $79.43 Typical High $275.42 | Professional | 54 · Surgery only | $44.67 | $79.43 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $15.85 Typical High $56.23 | Professional | 55 · Aftercare only | $8.91 | $15.85 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.47 Typical High $37.15 | Professional | 56 · Pre-op care only | $5.89 | $10.47 | $37.15 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 50 · Both sides | $346.74 | $346.74 | $346.74 |
Where Arkansas sits
The same service costs 4.9 times more in Iowa 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· 25th of 51
$263
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.