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 $77.62 Median $1,000.00 Typical High $2,041.74 | Facility | None | $77.62 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $158.49 | Professional | None | $77.62 | $128.82 | $158.49 |
BCBS Arkansas Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | None | $162.18 | $162.18 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $114.82 Typical High $263.03 | Professional | None | $57.54 | $114.82 | $263.03 |
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 $63.10 Median $138.04 Typical High $331.13 | Professional | None | $63.10 | $138.04 | $331.13 |
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 $38.90 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $38.90 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $24.55 Typical High $31.62 | Professional | 53 · Discontinued | $15.49 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $91.20 Typical High $120.23 | Professional | 54 · Surgery only | $58.88 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.20 Typical High $23.99 | Professional | 55 · Aftercare only | $11.75 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.76 | $12.30 | $15.85 |
Where Arkansas sits
The same service costs 3.7 times more in Wisconsin 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· 18th of 51
$162
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.