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 $426.58 Median $1,479.11 Typical High $2,344.23 | Facility | None | $426.58 | $1,479.11 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $933.25 Typical High $2,398.83 | Professional | None | $398.11 | $933.25 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $676.08 | Professional | None | $269.15 | $338.84 | $676.08 |
BCBS Arkansas Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $8,128.31 | Facility | None | $5,248.07 | $5,248.07 | $8,128.31 |
BCBS Arkansas Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $2,570.40 | Professional | None | $354.81 | $467.74 | $2,570.40 |
CareSource Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,398.83 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $870.96 Typical High $3,162.28 | Professional | None | $426.58 | $870.96 | $3,162.28 |
Qualchoice Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $776.25 | Professional | None | $223.87 | $316.23 | $776.25 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,456.54 Typical High $10,715.19 | Facility | None | $2,511.89 | $6,456.54 | $10,715.19 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,659.59 Typical High $3,467.37 | Professional | None | $338.84 | $1,659.59 | $3,467.37 |
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 $213.80 Median $407.38 Typical High $1,071.52 | Professional | 52 · Reduced service | $213.80 | $407.38 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $162.18 Typical High $426.58 | Professional | 53 · Discontinued | $85.11 | $162.18 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $602.56 Typical High $1,584.89 | Professional | 54 · Surgery only | $316.23 | $602.56 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $120.23 Typical High $316.23 | Professional | 55 · Aftercare only | $63.10 | $120.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $213.80 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $213.80 |
Where Arkansas sits
The same service costs 6.2 times more in Washington than in Maryland. 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· 26th of 51
$1,778
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.