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 $102.33 Median $1,000.00 Typical High $2,454.71 | Facility | None | $102.33 | $1,000.00 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $323.59 Typical High $380.19 | Professional | None | $102.33 | $323.59 | $380.19 |
BCBS Arkansas Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $302.00 | Facility | None | $138.04 | $218.78 | $302.00 |
BCBS Arkansas Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $457.09 | Professional | None | $91.20 | $120.23 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $147.91 Typical High $1,000.00 | Facility | None | $125.89 | $147.91 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $524.81 | Professional | None | $107.15 | $199.53 | $524.81 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $75.86 Median $275.42 Typical High $489.78 | Professional | None | $75.86 | $275.42 | $489.78 |
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 $50.12 Median $87.10 Typical High $190.55 | Professional | 52 · Reduced service | $50.12 | $87.10 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $34.67 Typical High $75.86 | Professional | 53 · Discontinued | $20.42 | $34.67 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $131.83 Typical High $281.84 | Professional | 54 · Surgery only | $75.86 | $131.83 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.30 Typical High $56.23 | Professional | 55 · Aftercare only | $15.14 | $26.30 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $17.38 Typical High $38.02 | Professional | 56 · Pre-op care only | $10.00 | $17.38 | $38.02 |
Where Arkansas sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 44th of 51
$219
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.