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 $70.79 Median $1,000.00 Typical High $2,041.74 | Facility | None | $70.79 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $134.90 | Professional | None | $66.07 | $95.50 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $141.25 | Professional | None | $81.28 | $114.82 | $141.25 |
BCBS Arkansas Setting Facility Modifier None Typical Low $70.79 Median $218.78 Typical High $302.00 | Facility | None | $70.79 | $218.78 | $302.00 |
BCBS Arkansas Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $128.82 | Professional | None | $52.48 | $69.18 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $74.13 Typical High $512.86 | Facility | None | $61.66 | $74.13 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $173.78 | Professional | None | $70.79 | $109.65 | $173.78 |
Qualchoice Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $190.55 | Professional | None | $93.33 | $162.18 | $190.55 |
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 $50.12 Median $97.72 Typical High $173.78 | Professional | None | $50.12 | $97.72 | $173.78 |
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 $35.48 Median $42.66 Typical High $58.88 | Professional | 52 · Reduced service | $35.48 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $23.99 | Professional | 53 · Discontinued | $14.13 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $63.10 Typical High $89.13 | Professional | 54 · Surgery only | $52.48 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $17.78 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.51 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.08 | $8.51 | $11.75 |
Where Arkansas sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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
$110
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.