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 $107.15 Median $1,000.00 Typical High $2,041.74 | Facility | None | $107.15 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $169.82 | Professional | None | $100.00 | $123.03 | $169.82 |
BCBS Arkansas Setting Facility Modifier None Typical Low $323.59 Median $630.96 Typical High $870.96 | Facility | None | $323.59 | $630.96 | $870.96 |
BCBS Arkansas Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $181.97 | Professional | None | $81.28 | $107.15 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $338.84 Typical High $575.44 | Facility | None | $281.84 | $338.84 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $263.03 | Professional | None | $100.00 | $154.88 | $263.03 |
United Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,548.82 | Facility | None | $269.15 | $363.08 | $1,548.82 |
United Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $251.19 | Professional | None | $75.86 | $134.90 | $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 $53.70 Median $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $53.70 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $24.55 Typical High $33.88 | Professional | 53 · Discontinued | $21.38 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.30 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.72 | $12.30 | $16.98 |
Where Arkansas sits
The same service costs 3.6 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· 12th of 51
$204
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.