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 $309.03 Median $1,071.52 Typical High $2,041.74 | Facility | None | $309.03 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $645.65 Typical High $1,047.13 | Professional | None | $281.84 | $645.65 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS Arkansas Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | None | $812.83 | $812.83 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $1,479.11 | Professional | None | $316.23 | $537.03 | $1,479.11 |
Qualchoice Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $436.52 | Professional | None | $269.15 | $269.15 | $436.52 |
United Setting Facility Modifier None Typical Low $128.82 Median $457.09 Typical High $776.25 | Facility | None | $128.82 | $457.09 | $776.25 |
United Setting Professional Modifier None Typical Low $245.47 Median $588.84 Typical High $1,737.80 | Professional | None | $245.47 | $588.84 | $1,737.80 |
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 $154.88 Median $275.42 Typical High $467.74 | Professional | 52 · Reduced service | $154.88 | $275.42 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $112.20 Typical High $190.55 | Professional | 53 · Discontinued | $61.66 | $112.20 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $416.87 Typical High $707.95 | Professional | 54 · Surgery only | $234.42 | $416.87 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $83.18 Typical High $141.25 | Professional | 55 · Aftercare only | $46.77 | $83.18 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $56.23 Typical High $95.50 | Professional | 56 · Pre-op care only | $30.90 | $56.23 | $95.50 |
Where Arkansas sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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
$813
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.