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 $186.21 Median $1,000.00 Typical High $2,041.74 | Facility | None | $186.21 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $229.09 | Professional | None | $181.97 | $194.98 | $229.09 |
BCBS Arkansas Setting Facility Modifier None Typical Low $89.13 Median $707.95 Typical High $977.24 | Facility | None | $89.13 | $707.95 | $977.24 |
BCBS Arkansas Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $239.88 | Professional | None | $141.25 | $177.83 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $512.86 | Facility | None | $83.18 | $97.72 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $316.23 | Professional | None | $134.90 | $234.42 | $316.23 |
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 $134.90 Median $169.82 Typical High $309.03 | Professional | None | $134.90 | $169.82 | $309.03 |
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 $91.20 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $91.20 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $138.04 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $19.50 | $22.91 |
Where Arkansas sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 24th of 51
$229
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.