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 $61.66 Median $1,174.90 Typical High $2,454.71 | Facility | None | $61.66 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $123.03 Typical High $177.83 | Professional | None | $53.70 | $123.03 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Arkansas Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | None | $114.82 | $114.82 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $245.47 | Professional | None | $63.10 | $97.72 | $245.47 |
Qualchoice Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $47.86 Median $109.65 Typical High $251.19 | Professional | None | $47.86 | $109.65 | $251.19 |
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 $30.20 Median $48.98 Typical High $89.13 | Professional | 52 · Reduced service | $30.20 | $48.98 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.50 Typical High $35.48 | Professional | 53 · Discontinued | $12.30 | $19.50 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $74.13 Typical High $131.83 | Professional | 54 · Surgery only | $45.71 | $74.13 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.79 Typical High $26.30 | Professional | 55 · Aftercare only | $9.12 | $14.79 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.77 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.17 | $9.77 | $17.78 |
Where Arkansas sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 28th of 51
$129
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.