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 $97.72 Median $1,071.52 Typical High $2,454.71 | Facility | None | $97.72 | $1,071.52 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $104.71 | Professional | None | $95.50 | $97.72 | $104.71 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,174.90 Median $2,630.27 Typical High $3,630.78 | Facility | None | $1,174.90 | $2,630.27 | $3,630.78 |
BCBS Arkansas Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | None | $74.13 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,071.52 Typical High $1,412.54 | Facility | None | $380.19 | $1,071.52 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $165.96 | Professional | None | $81.28 | $102.33 | $165.96 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,511.89 | Facility | None | $407.38 | $588.84 | $2,511.89 |
United Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $158.49 | Professional | None | $67.61 | $77.62 | $158.49 |
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 $47.86 Median $48.98 Typical High $50.12 | Professional | 52 · Reduced service | $47.86 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.50 Typical High $19.95 | Professional | 53 · Discontinued | $19.05 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $74.13 Typical High $75.86 | Professional | 54 · Surgery only | $72.44 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.77 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.55 | $9.77 | $10.00 |
Where Arkansas sits
The same service costs 11.2 times more in Tennessee than in New York. 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· 3rd of 51
$501
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.