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 $54.95 Median $1,174.90 Typical High $2,454.71 | Facility | None | $54.95 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $91.20 | Professional | None | $54.95 | $79.43 | $91.20 |
BCBS Arkansas Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Facility | None | $117.49 | $117.49 | $162.18 |
BCBS Arkansas Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $97.72 | Professional | None | $40.74 | $53.70 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $512.86 | Facility | None | $50.12 | $107.15 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $83.18 Typical High $128.82 | Professional | None | $50.12 | $83.18 | $128.82 |
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 $38.02 Median $69.18 Typical High $125.89 | Professional | None | $38.02 | $69.18 | $125.89 |
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 $27.54 Median $31.62 Typical High $44.67 | Professional | 52 · Reduced service | $27.54 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.88 Typical High $18.20 | Professional | 53 · Discontinued | $10.96 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $47.86 Typical High $67.61 | Professional | 54 · Surgery only | $41.69 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.55 Typical High $13.49 | Professional | 55 · Aftercare only | $8.32 | $9.55 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.31 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.50 | $6.31 | $9.12 |
Where Arkansas sits
The same service costs 3.4 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· 19th of 51
$91.20
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.